Evidence map›Paper›PMID 34453601›Full record

ArticlePediatric nephrology (Berlin, Germany)2022

Postnatal urinary tract dilatation classification: improvement of the accuracy in predicting kidney injury.

Fernanda F Melo, Mariana A Vasconcelos, Robert H Mak, Ana Cristina Simões E Silva, Cristiane S Dias, Enrico A Colosimo, Ludmila R Silva, Maria Christina L Oliveira, Eduardo A Oliveira

Abstract read
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In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Antenatally detected urinary tract dilatation: long-term outcome.Pediatric nephrology (Berlin, Germany) · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Fernanda F MeloPediatric Nephrourology Division, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R Engenheiro Amaro Lanari 389/501, Belo Horizonte, MG, 30310-580, Brazil.
Mariana A VasconcelosPediatric Nephrourology Division, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R Engenheiro Amaro Lanari 389/501, Belo Horizonte, MG, 30310-580, Brazil.
Robert H MakDivision of Pediatric Nephrology, Rady Children's Hospital San Diego, University of California, San Diego, La Jolla, CA, USA.
Ana Cristina Simões E SilvaPediatric Nephrourology Division, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R Engenheiro Amaro Lanari 389/501, Belo Horizonte, MG, 30310-580, Brazil.
Cristiane S DiasPediatric Nephrourology Division, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R Engenheiro Amaro Lanari 389/501, Belo Horizonte, MG, 30310-580, Brazil.
Enrico A ColosimoDepartment of Statistics, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
Ludmila R SilvaPediatric Nephrourology Division, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R Engenheiro Amaro Lanari 389/501, Belo Horizonte, MG, 30310-580, Brazil.
Maria Christina L OliveiraPediatric Nephrourology Division, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R Engenheiro Amaro Lanari 389/501, Belo Horizonte, MG, 30310-580, Brazil.
Eduardo A OliveiraPediatric Nephrourology Division, Department of Pediatrics, School of Medicine, Federal University of Minas Gerais (UFMG), R Engenheiro Amaro Lanari 389/501, Belo Horizonte, MG, 30310-580, Brazil. eduolive812@gmail.com.
Universidade Federal de Minas Gerais · BRRady Children's Hospital-San Diego · USUniversity of California, San Diego · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe grading of urinary tract dilatation (UTD) on postnatal sonography is a fundamental step to establish rational management for infants with antenatal hydronephrosis (ANH). The aim of this study was to compare the prediction accuracy of UTD grading systems for relevant clinical outcomes. In addition, we propose a refinement of the UTD classification by adding quantitative measurements and evaluate its impact on accuracy.

methodsBetween 1989 and 2019, 447 infants diagnosed with isolated AHN were prospectively followed. The events of interest were surgical interventions and kidney injury. Comparison of performance of the grading systems and the impact on the accuracy of a modified UTD classification (including the size of the kidney parenchyma) was assessed by the area under the receiver-operating characteristic curve (AUC).

resultsOf 447 infants, 131 (29%) underwent surgical intervention and 26 (5.8%) had developed kidney injury. The median follow-up time was 9 years (IQ range, 7-12 years). The performance for detecting the need for surgical intervention was excellent for all grading systems (AUC > 0.90). However, for predicting kidney injury, the modified UTD classification exhibited significant improvement in accuracy (AUC = 0.913, 95%CI, 0.883-0.937) as compared with UTD classification (AUC = 0.887, 95%CI, 0.854-0.915) (P = 0.027).

conclusionsOur study confirms that the hydronephrosis grading systems provide excellent accuracy in discriminating patients who need surgical intervention among infants with AHN. Our findings suggest that the inclusion of kidney parenchymal thickness to UTD classification might increase the accuracy for predicting infants who may develop kidney injury. A higher resolution version of the Graphical abstract is available as Supplementary information.

Indexed as

HydronephrosisUrinary TractDilatationFemaleHumansInfantKidneyMalePregnancyRetrospective StudiesUltrasonography, PrenatalFetal hydronephrosisUreteropelvic junction obstructionUrinary tract dilatationUrinary tract infection

Identifiers

PMID34453601
OpenAlexW3195011496

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.