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Suffering from congenital hydronephrosis. On Septrin prophylaxis. No improvement. What to do?

my baby suffers from congenital hydronephrosis G 3 with reflux of G 5 on right and G1 on left. He is on Septrin prophylaxis since the age of 2 months and that time his Creatinine level was only 19 micmol /l He is now 6 months and despite latest ultrasound showed some improvement on the right side becoming G 2 hydronephrosis but his creatinine has elevated from 31 to 37 micmol/l in 6 weeks! was it Septrine or teething or he needs intervention from urologist on the sationary left side that didn t show improvement?! I need a second opinion
Asked On : Tue, 12 Feb 2013
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Pediatrician, Surgery 's  Response
Thank you for your query.
Refluxes tend to resolve in the first year of life and resolution continues till 5 years age. Your child needs to be on chemoprohylaxis. As far as serum creatinine is concerned, it is lower in the early days of life and gradually increases as the child grows. That is the normal trend. Since his grades have gone down you should not worry. We would like to know whether his kidney is scarring or not. He will need a DMSA scan and then follow up scans. We are more interested on the level at which his creatinine settles down. He also needs a few more tests like renal dynamic scan to comment on individual function of the kidneys and unobstructed passage of urine from them. If he has voiding difficulties we need to rule a posterior urethral valves and also improper functioning of the bladder. You can get a second opinion from a pediatric surgeon also.
Hope that helps
God bless you
Answered: Tue, 12 Feb 2013
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