Fate of Antenatally Diagnosed Pelvi-ureteric Junction Obstruction
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CORRESPONDENCE
Fate of Antenatally Diagnosed Pelvi-ureteric Junction Obstruction Yogesh Kumar Sarin
Received: 23 June 2012 / Accepted: 30 November 2012 / Published online: 22 December 2012 # Dr. K C Chaudhuri Foundation 2012
To the Editor: I read article by Jain et al. [1] published in June 2012 issue of IJP with interest. I have the following reservations about the study design: 1. Did any of the patients in early pyeloplasty group have a non-obstructed renal scintigraphy curve at presentation? How many symptomatic patients in this subgroup had >40 % split renal function (SRF) with (a) obstructed renal curve, and (b) non-obstructed curve? 2. Although the authors mention under the heading ‘inclusion criteria’ that children having a follow-up of at least 24 mo or till their two consecutive renograms showed a non-obstructed pattern, either with or without operative correction, and later in follow up schedules that patients who underwent pyeloplasty had been followed up with physical examination, renal ultrasonography and scintigraphy at 3 mo, 6 mo and 1 y following the pyeloplasty, Fig. 1 shows that the follow up in at least few of the postpyeloplasty patients in delayed pyeloplasty group was barely 3 mo. 3. The change in renal function was considered significant only if the change was ≥5 %. Whereas such small variations in SRF may be important in patients having their SRF hovering around 40–50 %, the specificity and sensitivity of similar small changes may not be any clinical significance when observed in patients with poorly functioning kidneys with SRF of
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