AUTHOR=Vasconcelos Mariana A. , Oliveira Eduardo A. , Simões e Silva Ana Cristina , Dias Cristiane S. , Mak Robert H. , Fonseca Carolina C. , Campos Ana Paula M. , Steyerberg Ewout W. , Vergouwe Yvonne 

TITLE=A Predictive Model of Postnatal Surgical Intervention in Children With Prenatally Detected Congenital Anomalies of the Kidney and Urinary Tract

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 7 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2019.00120

DOI=10.3389/fped.2019.00120

ISSN=2296-2360

ABSTRACT=The aim of this study was to identify predictive factors of the need of surgery and to develop a model to assess individualized risk of 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 the need for surgical intervention. A predictive model was developed using Cox model with internal validation by bootstrap technique.  Of 694 patients, 164 (24%) infants needed surgical intervention in a median age of 7.8 months. Predictors of the need of surgery in the model were: baseline glomerular filtration rate, associated hydronephrosis, renal damage, renal pelvic dilatation severity, and period of admission.  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.