The aim of this study was to identify predictive factors and develop a model to assess individualized risk of postnatal surgical intervention in patients with antenatal hydronephrosis. This is a retrospective cohort study of 694 infants with prenatally detected congenital anomalies of kidney and urinary tract with a median follow-up time of 37 months. The main event of interest was postnatal surgical intervention. A predictive model was developed using Cox model with internal validation by bootstrap technique. Of 694 patients, 164 (24%) infants underwent surgical intervention in a median age of 7.8 months. Predictors of the surgical intervention in the model were: baseline glomerular filtration rate, associated hydronephrosis, presence of renal damage and the severity of renal pelvic dilatation. The optimism corrected c statistic for the model was 0.84 (95%CI, 0.82–0.87). The predictive model may contribute to identify infants at high risk for surgical intervention. Further studies are necessary to validate the model in patients from other settings.

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Keywords congenital anomalies of kidney and urinary tract, prenatal diagnosis, antenatal hydronephrosis, surgical intervention, predictive model
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Journal Frontiers in Pediatrics
Vasconcelos, M.A., Oliveira, E.A., Silva, A, Dias, C.S., Mak, R.H., Fonseca, C.C., … Vergouwe, Y. (2019). A Predictive Model of Postnatal Surgical Intervention in Children With Prenatally Detected Congenital Anomalies of the Kidney and Urinary Tract. Frontiers in Pediatrics, 7. doi:10.3389/fped.2019.00120