臨床泌尿器科70巻12号

2016年11月発行

特集 90分で習得できる! 先天性水腎症と膀胱尿管逆流のすべて 〈先天性水腎症〉

軽度水腎症の診療指針と経過観察の方法

著者： 小川哲史¹

所属機関： ¹虎の門病院小児科

ページ範囲：P.906 - P.912

▶ポイント

・軽度の先天性水腎症（腎盂尿管移行部通過障害）はほとんどの例で自然軽快することから，診療指針としては超音波検査による定期的な経過観察が主体となる．

・高度水腎症であっても経過観察が可能な症例もあるが，腎機能障害進行の可能性を踏まえ，手術介入のタイミングに十分に注意したうえで診療すべきである．

・出生前に胎児超音波検査によって診断される水腎症の多くは自然軽快するが，腎盂前後径の拡張が高度なものでは手術に至る可能性もある．

・先天性水腎症に対する予防的抗菌薬投与に関するエビデンスは乏しく，確立されたコンセンサスは得られていない．

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