Hydronephrosis in Child
In children, hydronephrosis is most often secondary to an anatomic abnormality such as posterior urethral valves, vesicoureteral reflux, or ureteropelvic junction (UPJ) obstruction. Congenital anomalies account for a higher incidence of hydronephrosis in children compared to adults.
The Society for Fetal Urology (SFU) has developed a grading system for the severity of hydronephrosis. Severity ranges from grade 0 (mild; no renal pelvis dilation) to grade 4 (severe; dilation of the renal pelvis and calyces and thinning of the renal parenchyma).
Patients with isolated hydronephrosis are typically pain free; the presence of pain is usually in the setting of stones, acute bladder distension, or infection. Upper ureteral or renal pelvic lesions typically cause flank pain, whereas lower ureteral obstruction causes pain that radiates to the ipsilateral testicle or labia. Other presenting symptoms include hypertension, change in urine output, hematuria, or new creatinine elevation on routine laboratory studies.
N13.30 – Unspecified hydronephrosis
43064006 – Hydronephrosis
Differential Diagnosis & Pitfalls
Drug Reaction Data