A clinical predictive model of renal injury in children with isolated antenatal hydronephrosis

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dc.creatorFernanda P. Costa
dc.creatorAna C. Simões e Silva
dc.creatorRobert H. Mak
dc.creatorJoachim H. Ix
dc.creatorMariana A. Vasconcelos
dc.creatorCristiane Dos Santos Dias
dc.creatorCarolina C. Fonseca
dc.creatorMaria Christina L. Oliveira
dc.creatorEduardo A. Oliveira
dc.date.accessioned2023-08-02T22:25:24Z
dc.date.accessioned2025-09-08T23:45:05Z
dc.date.available2023-08-02T22:25:24Z
dc.date.issued2019-08-19
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.1093/ckj/sfz102
dc.identifier.issn2048-8513
dc.identifier.urihttps://hdl.handle.net/1843/57391
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofClinical Kidney Journal
dc.rightsAcesso Aberto
dc.subjectInsuficiência Renal Crônica
dc.subjectHipertensão
dc.subjectProteinuria
dc.subjectInjúria Renal Aguda
dc.subjectInfecções Urinárias
dc.subject.otherAntenatal hydronephrosis
dc.subject.otherChronic kidney disease
dc.subject.otherClinical prediction model
dc.subject.otherhypertension
dc.subject.otherProteinuria
dc.subject.otherRenal injury
dc.subject.otherUrinary tract infection
dc.titleA clinical predictive model of renal injury in children with isolated antenatal hydronephrosis
dc.typeArtigo de periódico
local.citation.epage841
local.citation.issue5
local.citation.spage834
local.citation.volume13
local.description.resumoBackground. Antenatal hydronephrosis (ANH) affects 1–5% of pregnancies. The aim of this study was to develop a clinical prediction model of renal injury in a large cohort of infants with isolated ANH. Methods:This is a longitudinal cohort study of 447 infants with ANH admitted since birth between 1989 and 2015 at a tertiary care center. The primary endpoint was time until the occurrence of a composite event of renal injury, which includes proteinuria, hypertension and chronic kidney disease (CKD). A predictive model was developed using a Cox proportional hazards model and evaluated by C-statistics.Results: Renal pelvic dilatation (RPD) was classified into two groups [Grades 1–2 (n ¼ 255) versus Grades 3–4 (n ¼ 192)]. The median follow-up time was 6.4 years (interquartile range 2.8–12.5). Thirteen patients (2.9%) developed proteinuria, 6 (1.3%) hypertension and 14 (3.1%) CKD Stage 2. All events occurred in patients with RPD Grades 3–4. After adjustment, three covariables remained as predictors of the composite event: creatinine {hazard ratio [HR] 1.27, [95% confidence interval (CI) 1.05–1.56]}, renal parenchyma thickness at birth [HR 0.78(95% CI 0.625–0.991)] and recurrent urinary tract infections [HR 4.52 (95% CI 1.49–13.6)]. The probability of renal injury at 15 years of age was estimated as 0, 15 and 24% for patients assigned to the low-risk, medium-risk and high-risk groups, respectively (P < 0.001).Conclusion: Our findings indicate an uneventful clinical course for patients with Society for Fetal Urology (SFU) Grades 1–2 ANH. Conversely, for infants with SFU Grades 3–4 ANH, our prediction model enabled the identification of a subgroup of patients with increased risk of renal injury over time.
local.identifier.orcid0000-0001-6559-3300
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE PEDIATRIA
local.publisher.initialsUFMG
local.url.externahttps://academic.oup.com/ckj/article/13/5/834/5551403

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