HYDRONEPHROSIS WITH DIFFUSE OR SEGMENTAL CORTICAL THINNING: IMPACT ON RENAL FUNCTION
Bibliographic record
Abstract
PURPOSE: Management of hydronephrosis has changed considerably with the routine use of prenatal ultrasonography. Increased dependence is now placed on nuclear renographic differential renal function, and many urologists consider surgical intervention for ureteropelvic junction obstruction with significant decrease in renal function (less than 40%). Correlation between differential renal function and the degree of dilatation diagnosed by ultrasound has not been reported. In addition, no difference between hydronephrosis associated with either diffuse or segmental cortical thinning has been made, as both are classified as grade IV according to the Society of Fetal Urology classification. Based on clinical observation we hypothesized that hydronephrotic grade IV kidneys with diffuse parenchymal thinning are associated with worse renal function and are distinct from those with segmental cortical thinning. MATERIALS AND METHODS: We performed a retrospective study of patients who underwent pyeloplasty between January 1996 and December 1998. Hydronephrosis was graded according to Society for Fetal Urology classification and all diuretic renograms were performed in a standardized fashion. Grade IV kidneys were divided into IVA (segmental cortical thinning) and IVB (diffuse cortical thinning). Statistical correlation of grade and differential renal function was performed using a chi-square test. RESULTS: Images were available for review in 77 patients. Average patient age at intervention was 20.4 months and 7.6 years of the prenatally and postnatally detected hydronephrosis groups, respectively. Of the 77 cases 25 had grade IVA and 18 had grade IVB hydronephrosis. Of the grade IVB hydronephrosis cases 66% had less than 40% differential renal function compared to 24% in group IVA (p <0.05). CONCLUSIONS: Patients with grade IVB hydronephrosis secondary to ureteropelvic junction obstruction have a higher risk of significant decrease in renal function. Group IVA has significantly better function than group IVB and characteristics similar to grade III hydronephrosis cases. Grade IVB hydronephrosis should monitorized closely as earlier intervention may be warranted to avoid progressive deterioration of renal function.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".