Year: 2026
Type: article
Study design: Observational Study
Abstract: Objectives While early outcomes after pyeloplasty are well‐documented, long‐term split renal function (SRF) stability, particularly beyond puberty, remains unclear. This study evaluates SRF after prepubertal pyeloplasty and identifies factors associated with late deterioration. Methods A retrospective review included paediatric patients who underwent pyeloplasty between 2000 and 2025. Exclusion criteria were solitary kidney, missing imaging, congenital anomalies or prior pyeloplasty. Patients were categorised into two groups: Group 1 (no deterioration) and Group 2 (late deterioration after puberty), based on ≥5% decrease in SRF. Clinical, surgical and imaging parameters were compared among groups using Chi‐square, Fisher's exact and Mann–Whitney U tests, with multivariate logistic regression to identify predictors of late deterioration. Results Out of 1493 patients, 191 were included: 152 (79.6%) in Group 1 and 39 (20.4%) in Group 2. Group 2 patients were younger at surgery, had more frequent renal pelvis reduction and persistent hydronephrosis at 1‐year follow‐up ( p < 0.001). Multivariate analysis identified renal pelvis reduction (odds ratio [OR] = 9.82, 95% confidence interval [CI]: 3.551–37.799, p < 0.001) and non‐resolution of hydronephrosis (OR = 4.811, 95% CI: 1.766–13.1, p = 0.002), as late deterioration predictors. Older age at surgery (OR = 0.958, 95% CI: 0.942–0.975, p < 0.001) and higher final SRF (OR = 0.905, 95% CI: 0.855–0.958, p < 0.001) were protective against deterioration. Conclusion SRF may deteriorate after puberty despite initial post‐operative stability. Renal pelvis reduction, persistent hydronephrosis at 1 year and younger age at surgery are associated with increased risk of deterioration.
Source: BJUI Compass
DOI: 10.1002/bco2.70159
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,770
Funder: Mansoura University
OpenAlex ID: W7127080763