Citation, DOI, disclosures and article data
Citation:
Knipe H, Campos A, Chieng R, et al. Neonatal hydronephrosis. Reference article, Radiopaedia.org (Accessed on 26 Feb 2025) https://doi.org/10.53347/rID-36967
Neonatal hydronephrosis is most commonly diagnosed antenatally as fetal pylectasis, and in the majority of cases is due to pelviureteric junction (PUJ) obstruction.
Etiology
The degree of neonatal hydronephrosis can be classified by urinary tract dilatation classification.
Ultrasound
Renal pelvis AP diameter of >7-10 mm is considered significant 3,4; this is not absolute and varies by institution. It can be classified according to severity of hydronephrosis 7:
grade 1: mildly dilated renal pelvis without calyceal dilatation
grade 2: further dilation of renal pelvis with dilatation of some calyces
grade 3: renal pelvis and calyces are dilated, however, the renal parenchymal thickness is normal
grade 4: all features of grade 3, together with thinning of renal parenchyma
Treatment and prognosis
The estimated incidence of neonatal hydronephrosis that has clinical significance is 1 in 600 and most cases will resolve without intervention 5.
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2. Psooy K, Pike J. Investigation and management of antenatally detected hydronephrosis. Can Urol Assoc J. 2011;3 (1): 69-72. Free text at pubmed - Pubmed citation
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5. Nerli RB, Amarkhed SS, Ravish IR. Voiding cystourethrogram in the diagnosis of vesicoureteric reflux in children with antenatally diagnosed hydronephrosis. Ther Clin Risk Manag. 2011;5 (1): 35-9. Free text at pubmed - Pubmed citation
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6. Brown T, Mandell J, Lebowitz RL. Neonatal hydronephrosis in the era of sonography. AJR Am J Roentgenol. 1987;148 (5): 959-63. doi:10.2214/ajr.148.5.959 - Pubmed citation
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7. Choi Y, Cheon J, Kim W, Kim I. Ultrasonography of Hydronephrosis in the Newborn: A Practical Review. Ultrasonography. 2016;35(3):198-211. doi:10.14366/usg.15073 - Pubmed
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