Childhood Kidney Diseases
- Volume 3 Issue 2
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- Pages.203-208
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- 1999
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- 2384-0242(pISSN)
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- 2384-0250(eISSN)
The Role of Initial Relative Renal Function in Unilateral Hydronephrosis
일측 폐색성 및 역류성 수신증에서 술전 상대적 신기능의 의미
- Han Sang-Won (Department of Urology, Yonsei University, College of Medicine) ;
- Kang Seon-Jung (Department of Urology, Yonsei University, College of Medicine) ;
- Kwon Min-Jung (Department of Pediatrics, Inha University, College of Medicine) ;
- Kim Dae-Joong (Department of Anatomy, Inha University, College of Medicine) ;
- Choi Seung-Kang (Department of Urology, Yonsei University, College of Medicine) ;
- Lee Tack (Department of Urology, Inha University, College of Medicine)
- 한상원 (연세대학교 의과대학 비뇨기과학교실) ;
- 강선중 (연세대학교 의과대학 비뇨기과학교실) ;
- 권민중 (인하대학교 의과대학 소아과학교실) ;
- 김대중 (인하대학교 의과대학 해부학교실) ;
- 최승강 (연세대학교 의과대학 비뇨기과학교실) ;
- 이택 (인하대학교 의과대학 비뇨기과학교실)
- Published : 1999.10.01
Abstract
Purpose: The information on the change of the relative renal function after operation is essential to set the initial treatment plan in unilateral hydronephrosis. So we analyzed the preoperative and postoperative relative renal function, and observed the functional changes by operation and reliability of the various factors in those changes. Materials and Methods: A retrospective trial was done of 81 patients, 35 ureteropelvic junction(UPJ) obstruction and 46 vesicoureteral reflux(VUR), among 393 patients undergoing operations at our institution from March. 1992 to February. 1997. The patients who had infravesical abnormalities, abnormal contralateral kidney and insufficient research data were excluded. We determined the relative renal functions using DTPA and MAG3 scan in UPJ obstruction and DMSA scan in VUR. The mean observation period after operation was 2.01(0.25-4) years. Results: A. UPJ Obstruction 1. The relative renal function was improved significantly after operation(P=0.0007). 2. The kidneys which have preoperative functions between 20% and 40% improved significantly in relative renal function comparing to the kidneys of the other functions(P=0.0046). B. VUR 1. The renal functions didn't improve significantly after operation(P>0.05). 2. There was no significant factor affecting the prognosis in renal functions. Conclusions: 1. The kidneys with UPJ Obstruction show the difference in functional improvement after operation according to the degree of the preoperative renal function, but more investigations about the exact value are needed. 2. In VUR there was no difference between preoperative and postoperative functions, the theoretical basis on objectives of the operation could be the symptoms or factors except the operation.
목적 : 신생아 시기에 일측성 수신증의 자연경과는 여러 요인들에 의해 변화되는데, 그중에서도 술전의 신기능은 일측 뿐 아니라 양측성 수신증의 초기 치료 지침을 세우는데 매우 중요한 의미를 가진다. 따라서 저자들은 일측성 수신증(폐색과 역류)을 가진 환아에서 환측신의 치료전과 후 상대적 신기능의 변화를 관찰하여 수신증의 예후에 미치는 영향을 관찰하고자 하였다. 방법 : 1992년 3월부터 1997년 2월까지 수술적으로 교정한 수신증 환자 393명(폐색성 108, 역류성 285)중 술후에 합병증 없이 치료가 끝나고 수술전후에 자료가 충실한 81명(폐색성 35, 역류성 46)을 대상으로 하였다. 환자들의 평균 나이는 폐색 환자에서 2.62(0.02-15)세, 역류 환자에서 3.14(0.5-15)세였으며, 평균 추적관찰 기간은 2.01(0.25-4)년이었다. 상대적 신기능은 폐색 환자에서