Intermediate term outcomes associated with the surveillance of XXXX in adults.

@entity1 @entity2885 @entity158 @entity4145
PURPOSE: We determined the outcome of minimally symptomatic adult @entity4145 in a group of @entity1 treated conservatively with an active surveillance regimen. MATERIALS AND METHODS: A total of 27 @entity1 with asymptomatic or minimally symptomatic @entity4145 were treated conservatively. All @entity1 were evaluated with diuretic renograms. @entity4145 was defined by an obstructive pattern of the clearance curve and/or T1/2 greater than 20 minutes. Followup consisted of an office visit and renogram every 6 to 12 months. Cases of greater than 10% loss of relative renal function of the affected kidney, development of @entity2885 and/or more than 1 episode of acute @entity158 were considered active surveillance failures, and treatment was recommended. RESULTS: Of the 27 @entity1 6 were lost to followup, leaving 21 (median age 47 years) with sufficient followup for analysis. In the 4 @entity1 (19%) who initially presented with mild @entity158 that led to the diagnosis of @entity4145 , the @entity158 completely resolved. Ipsilateral relative renal function decreased significantly in 2 @entity1 (9.5%, mean reduction 14%). @entity158 worsened in 3 @entity1 (14.3%) and de novo @entity158 occurred in 1 (4.7%). Surgical intervention for @entity4145 was required in 6 @entity1 (29%) at an average of 34 months. In total 15 @entity1 (71%) remained on surveillance with a mean followup of 48 months. CONCLUSIONS: Active surveillance seems to be a reasonable initial option for asymptomatic or mildly symptomatic adult @entity1 with @entity4145 because only approximately 30% have progression to surgical intervention within 4 years of diagnosis. This strategy offers the advantage of individualizing therapy according to symptoms and renographic findings.
