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8 Cards in this Set
- Front
- Back
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When is the initial post-natal US performed for suspected UPJO?
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-w/in 48hrs if severe bil antenatal hydro and concerned with PUV (VCUG w/in 1st week if severe bil hydro, o/w 1mo)
-at 1mo if unilateral severe hydro (VCUG at 1-2 mos if hydro persists) |
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what is the renal parenchyma-pelvicaliceal area ratio to improve dx accuracy of US?
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ration <1.6 correlates with significant obstruction
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RI assoc with obst pattern on RUS?
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>0.75
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What are the indications for intervention in UPJO?
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"BRUSSSHH"
Bilateral disease Renal dysfcn (<40% w/ poor washout or dec serial fcn) UTI's Solitary kidney Symptoms Stones Hydro increasing on serial studies HTN |
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What is the predictive value of GFR in infants with renal dysplasia?
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est GFR @ 6mos <15mL/min/1.73m2 is predictive of early renal failure
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What are the 4 main effects of obstruction on the developing kidney?
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Alterations in:
1. regulation of growth (hypoplasia) 2. tissue differentiation (dysplasia) 3. structure (ECM and fibrosis) 4. functional integration of kidney (result of above) |
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What is the hallmark histologic sign of renal dysplasia?
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fibromuscular collars around tubular structures (primitive ducts); presence of collagen
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what are the normal fetal urinary indices?
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Tubule fcn:
Na <100 mEq/L Cl <90 mEq/L osmolality <210 mOsm/L Not leaking protein: urine total protein <20 mg/dL B2-microglobulin <4 mg/L low fetal urine NAG and valine levels |
