Swiss Consensus on Prenatal and Early Postnatal Urinary Tract Dilation: Practical Approach and When to Refer
Atessa Bahadori,
Alexandra Wilhelm-Bals,
Julien Caccia,
Hassib Chehade,
Alexandra Goischke,
Céline Habre,
Daniela Marx-Berger,
Samuel Nef,
Oliver Sanchez,
Giuseppina Spartà,
Isabelle Vidal,
Rodo O. von Vigier,
Jacques Birraux,
Paloma Parvex
Affiliations
Atessa Bahadori
Nephrology Unit, Paediatric Specialties Division, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland
Alexandra Wilhelm-Bals
Nephrology Unit, Paediatric Specialties Division, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland
Julien Caccia
Division of Paediatric Nephrology, University Children’s Hospital, 3010 Bern, Switzerland
Hassib Chehade
Paediatric Nephrology Unit, Paediatric Division, Woman-Mother-Child Department, Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland
Alexandra Goischke
Nephrology Department, University Children’s Hospital (UKBB), 4031 Basel, Switzerland
Céline Habre
Division of Radiology, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland
Daniela Marx-Berger
Paediatric Nephrology, Children’s Hospital of Eastern Switzerland (OKS), 9006 St. Gallen, Switzerland
Samuel Nef
Paediatric Department, Cantonal Hospital of Winterthur, 8400 Winterthur, Switzerland
Oliver Sanchez
Division of Child’s and Adolescent’s Surgery, Department of Pediatrics, Gynecology, and Obstetrics, University Center of Pediatric Surgery of Western Switzerland, 1004 Lausanne, Switzerland
Giuseppina Spartà
Nephrology Unit, University Children’s Hospital Zurich, 8008 Zurich, Switzerland
Isabelle Vidal
Division of Child’s and Adolescent’s Surgery, Department of Paediatrics, Gynecology, and Obstetrics, University Center of Paediatric Surgery of Western Switzerland, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland
Division of Child’s and Adolescent’s Surgery, Department of Paediatrics, Gynecology, and Obstetrics, University Center of Paediatric Surgery of Western Switzerland, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland
Paloma Parvex
Nephrology Unit, Paediatric Specialties Division, Geneva University Hospitals (HUG), 1205 Geneva, Switzerland
Urinary tract dilations (UTDs) are the most frequent prenatal renal anomaly. The spectrum of etiologies causing UTD ranges from mild spontaneously resolving obstruction to severe upper and lower urinary tract obstruction or reflux. The early recognition and management of these anomalies allows for improved renal endowment prenatally and ultimately better outcome for the child. The role of the general obstetrician and pediatrician is to recognize potential prenatal and postnatal cases addressed to their practice and to refer patients to specialized pediatric nephrology and urology centers with a sense of the urgency of such a referral. The aim of this paper is to offer clinical recommendations to clinicians regarding the management of neonates and children born with prenatally detected UTD, based on a consensus between Swiss pediatric nephrology centers. The aim is to give suggestions and recommendations based on the currently available literature regarding classifications and definitions of prenatal and postnatal UTD, etiologies, prenatal and postnatal renal function evaluation, investigations, antibiotic prophylaxis, and the need for referral to a pediatric nephrologist and/or urologist. The overarching goal of a systematic approach to UTD is to ultimately optimize kidney health during childhood and improve long-term renal function prognosis.
