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.
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