No abstract

The aim of this study was to detect possible risk factors for UC and UTI following pediatric renal Tx and effect of these complications on outcome. One hundred and eight children who underwent living donor Tx between 2009 and 2015 were retrospectively included. Extraperitoneal approach was used with stented tunneled extravesical procedure. Mean recipient age was 9.89 ± 3.46 years while mean weight was 25.22 ± 10.43 kg. Seventy-three (67.6%) recipients were boys while 92 (85.2%) were related to donors. Urological causes of ESRD were present in 33 (30.6%) recipients (14 [13%] posterior urethral valve, 16 [14.8%] VUR, and 3 [2.8%] neurogenic bladder). Augmentation ileocystoplasty was performed in 9 (8.3%) patients. Mean follow-up was 39.3 ± 17.33 months. UC were detected in 10 (9.3%) children (leakage 4 [3.7%], obstruction 3 [2.8%], and VUR 3 [2.8%]) while UTIs were reported in 40 (37%) children. After logistic regression analysis, UC were significantly higher in children with cystoplasty (44.4% vs 6.1%; P = .001). UTIs were significantly higher in girls (51.4% vs 30.1%; P = .001) and in children with urological causes of ESRD (51.5% vs 30.7%; P = .049). UC and UTI were not significantly associated with increased graft loss or mortality. UC were significantly higher in children with cystoplasty while UTIs were significantly higher in girls and children with urological causes of ESRD. Presence of UC did not affect the rate of graft loss or mortality due to its early detection and proper management.

Background: Children with renal and urinary tract diseases may require admission in general pediatric wards. Aim of the work:To identify the pattern of renal and urinary tract diseases among children admitted to general pediatric ward and their associated morbidities and mortality. Methods: Retrospective analysis of files of children with confirmed diagnosis of renal and urinary tract diseases who were admitted to a general pediatric ward, at Children Hospital, Cairo University. Results: During 12 months, 142 patients with renal or urinary tract disease were admitted to our pediatric general ward. Of them 97 (68.3%) were boys and 45 (31.7%) were girls. Their mean age was 5.1 ± 3.89 years. Of them 121 (85.2%) had isolated renal disease and 21 (14.8%) had renal affection as a part of systemic diseases. The most common diseases among those with isolated renal disease, were glomerular diseases (62 patients, 51.2%), followed by congenital anomalies of the kidney and urinary tract (33 patients, 27.3%). Different types of infection were the main cause for admission among 78 (54.9%) children. Thirty four patients (23.9%) underwent renal replacement therapy, and 26 patients suffered from poor outcome. Conclusion:Pediatricians should have the knowledge of the different presentations of renal disease in children and be trained for timely referral to the pediatric nephrologists and/or urologist. Renal diseases should be suspected in those with diseases of other systems. Infections are the commonest renal indication of admission in the general pediatric ward.