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Can We Further Improve the Quality of Nephro-Urological Care in Children with Myelomeningocele?

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ABSTRACT

Myelomeningocele (MMC) results from a failure of normal neural tube fusion in early fetal development. Retrospective, observational study of medical data of 54 children treated in Pediatric Nephrology and Urology Clinics for five years was performed. The following data were analyzed: serum creatinine, eGFR, urine analysis, renal scintigraphy (RS), renal ultrasound, and urodynamics. Mean age of studied population: 12.3 years, median of eGFR at the beginning and at the end of survey was 110.25 and 116.5 mL/min/1.73 m2 accordingly. Median of frequency of urinary tract infections (fUTI): 1.2 episodes/year. In 24 children: low-pressure, in 30 children: high-pressure bladder was noted. Vesicouretral reflux (VUR) was noted in 23 children (42.6%). fUTI were more common in high-grade VUR group. High-grade VURs were more common in group of patients with severe renal damage. At the end of the survey 11.1% children were qualified to higher stages of chronic kidney disease. Renal parenchyma damage progression in RS was noted in 22.2% children. Positive VUR history, febrile recurrent UTIs, bladder wall trabeculation, and older age of the patients constitute risk factors of abnormal renal scans. More than 2.0 febrile, symptomatic UTIs annually increase by 5.6-fold the risk of severe renal parenchyma damage after five years.

No MeSH data available.


Correlation between patients age (months) vs. eGFR value at the end of five-year survey; (r = −0.444; p = 0.008).
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ijerph-13-00876-f001: Correlation between patients age (months) vs. eGFR value at the end of five-year survey; (r = −0.444; p = 0.008).

Mentions: Children with severe kidney parenchymal damage were also significantly older as compared to children without or with moderate damage (RS: 129.2 vs. 183.8 (months) (RS1 vs. 3); 140.8 vs. 183.8 (months) (RS1 + 2 vs. 3)). Moreover, a negative, average, significant correlation was noted between the age of the patients expressed in months and kidney function expressed as the eGFR value (r = −0.444; p = 0.008) (Figure 1). No correlation was observed, however, between the age of the patients and fUTI.


Can We Further Improve the Quality of Nephro-Urological Care in Children with Myelomeningocele?
Correlation between patients age (months) vs. eGFR value at the end of five-year survey; (r = −0.444; p = 0.008).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5036709&req=5

ijerph-13-00876-f001: Correlation between patients age (months) vs. eGFR value at the end of five-year survey; (r = −0.444; p = 0.008).
Mentions: Children with severe kidney parenchymal damage were also significantly older as compared to children without or with moderate damage (RS: 129.2 vs. 183.8 (months) (RS1 vs. 3); 140.8 vs. 183.8 (months) (RS1 + 2 vs. 3)). Moreover, a negative, average, significant correlation was noted between the age of the patients expressed in months and kidney function expressed as the eGFR value (r = −0.444; p = 0.008) (Figure 1). No correlation was observed, however, between the age of the patients and fUTI.

View Article: PubMed Central - PubMed

ABSTRACT

Myelomeningocele (MMC) results from a failure of normal neural tube fusion in early fetal development. Retrospective, observational study of medical data of 54 children treated in Pediatric Nephrology and Urology Clinics for five years was performed. The following data were analyzed: serum creatinine, eGFR, urine analysis, renal scintigraphy (RS), renal ultrasound, and urodynamics. Mean age of studied population: 12.3 years, median of eGFR at the beginning and at the end of survey was 110.25 and 116.5 mL/min/1.73 m2 accordingly. Median of frequency of urinary tract infections (fUTI): 1.2 episodes/year. In 24 children: low-pressure, in 30 children: high-pressure bladder was noted. Vesicouretral reflux (VUR) was noted in 23 children (42.6%). fUTI were more common in high-grade VUR group. High-grade VURs were more common in group of patients with severe renal damage. At the end of the survey 11.1% children were qualified to higher stages of chronic kidney disease. Renal parenchyma damage progression in RS was noted in 22.2% children. Positive VUR history, febrile recurrent UTIs, bladder wall trabeculation, and older age of the patients constitute risk factors of abnormal renal scans. More than 2.0 febrile, symptomatic UTIs annually increase by 5.6-fold the risk of severe renal parenchyma damage after five years.

No MeSH data available.