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Commentary to ‘Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system)’

Published:November 13, 2014DOI:https://doi.org/10.1016/j.jpurol.2014.10.001
      Appropriate management of neonatal urinary tract dilation is a challenge to clinicians in various medical specialties. One initial obstacle to good care, or even to high-quality clinical evidence to guide care, is the lack of a widely accepted method of categorizing this problem. The development of standardized classification criteria for chronic kidney disease [
      • Levey A.S.
      • Eckardt K.U.
      • Tsukamoto Y.
      • Levin A.
      • Coresh J.
      • Rossert J.
      • et al.
      Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO).
      ] and acute kidney injury [
      • Mehta R.L.
      • Kellum J.A.
      • Shah S.V.
      • Molitoris B.A.
      • Ronco C.
      • Warnock D.G.
      • et al.
      Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury.
      ,
      • Bellomo R.
      • Ronco C.
      • Kellum J.A.
      • Mehta R.L.
      • Palevsky P.
      Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the second international consensus conference of the Acute Dialysis Quality Initiative (ADQI) Group.
      ] has allowed for large-scale studies [
      • Ricci Z.
      • Cruz D.
      • Ronco C.
      The RIFLE criteria and mortality in acute kidney injury: a systematic review.
      ,
      • Lash J.P.
      • Go A.S.
      • Appel L.J.
      • He J.
      • Ojo A.
      • Rahman M.
      • et al.
      Chronic Renal Insufficiency Cohort (CRIC) Study: baseline characteristics and associations with kidney function.
      ] that have greatly advanced our understanding of these diseases. Currently, many classification schemes exist for neonatal urinary tract dilation, none of which are widely accepted by all medical specialties involved in the care of patients with this condition.
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      References

        • Levey A.S.
        • Eckardt K.U.
        • Tsukamoto Y.
        • Levin A.
        • Coresh J.
        • Rossert J.
        • et al.
        Definition and classification of chronic kidney disease: a position statement from Kidney Disease: Improving Global Outcomes (KDIGO).
        Kidney Int. 2005; 67: 2089-2100
        • Mehta R.L.
        • Kellum J.A.
        • Shah S.V.
        • Molitoris B.A.
        • Ronco C.
        • Warnock D.G.
        • et al.
        Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury.
        Crit Care. 2007; 11: R31
        • Bellomo R.
        • Ronco C.
        • Kellum J.A.
        • Mehta R.L.
        • Palevsky P.
        Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: the second international consensus conference of the Acute Dialysis Quality Initiative (ADQI) Group.
        Crit Care. 2004; 8: R204-R212
        • Ricci Z.
        • Cruz D.
        • Ronco C.
        The RIFLE criteria and mortality in acute kidney injury: a systematic review.
        Kidney Int. 2008; 73: 538-546
        • Lash J.P.
        • Go A.S.
        • Appel L.J.
        • He J.
        • Ojo A.
        • Rahman M.
        • et al.
        Chronic Renal Insufficiency Cohort (CRIC) Study: baseline characteristics and associations with kidney function.
        Clin J Am Soc Nephrol. 2009; 4: 1302-1311

      Linked Article

      • Multidisciplinary consensus on the classification of prenatal and postnatal urinary tract dilation (UTD classification system)
        Journal of Pediatric UrologyVol. 10Issue 6
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          Urinary tract (UT) dilation is sonographically identified in 1–2% of fetuses and reflects a spectrum of possible uropathies. There is significant variability in the clinical management of individuals with prenatal UT dilation that stems from a paucity of evidence-based information correlating the severity of prenatal UT dilation to postnatal urological pathologies. The lack of correlation between prenatal and postnatal US findings and final urologic diagnosis has been problematic, in large measure because of a lack of consensus and uniformity in defining and classifying UT dilation.
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