Case study

A newborn male infant was noted to have unilateral hydronephrosis with a 10mm APRPD on prenatal ultrasound at 30 weeks of pregnancy. At 36 weeks of pregnancy, the left APRPD had increased to 13 mm with no dilation of the ureter.
At 7 days of age, a renal and bladder ultrasound showed 15mm of the left APRPD without thinning of the renal parenchyma. No ureteral dilation was detected.
RUS repeated at the age of one month showing 25 mm APRPD with increased length of the left kidney, thinning of the parenchyma, and dilated calyces.
A diuretic renography was planned.

The different classifications of obstructive uropathy can be broken down as follows:

What we can deduce?

• Diuretic renography showed an obstructed pattern of the left UPJ.
• There was no response to the diuretic injection.
• Surgical intervention was planned.