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

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.


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ROC curve for severe renal damage risk (RS3 vs. RS1 + 2) evaluated in RS depending on fUTI.
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ijerph-13-00876-f002: ROC curve for severe renal damage risk (RS3 vs. RS1 + 2) evaluated in RS depending on fUTI.

Mentions: As it follows from the analysis of the ROC curve for fUTI after five years of the follow-up, with a cut-off value of fUTI of 2.0 annually (at 64.6% sensitivity, 83.5% specificity and 80% AUROC—what denotes a good prognostic value of the parameter), the risk of severe kidney damage in RS (RS3) increased 5.6-fold (Figure 2).


Can We Further Improve the Quality of Nephro-Urological Care in Children with Myelomeningocele?
ROC curve for severe renal damage risk (RS3 vs. RS1 + 2) evaluated in RS depending on fUTI.
© Copyright Policy
Related In: Results  -  Collection

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

ijerph-13-00876-f002: ROC curve for severe renal damage risk (RS3 vs. RS1 + 2) evaluated in RS depending on fUTI.
Mentions: As it follows from the analysis of the ROC curve for fUTI after five years of the follow-up, with a cut-off value of fUTI of 2.0 annually (at 64.6% sensitivity, 83.5% specificity and 80% AUROC—what denotes a good prognostic value of the parameter), the risk of severe kidney damage in RS (RS3) increased 5.6-fold (Figure 2).

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.


Related in: MedlinePlus