Estudio del daño renal en el paciente pediátrico con vejiga neurógena y su relación con el patrón de funcionamiento vesical y el tratamiento recibido

Rodríguez-Ruiz, M.; Argibay, Iván Somoza; Curros-Mata, N.

doi:10.1016/j.acuro.2015.06.002

Cited by 6 publications

(6 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The incidence of renal scarring in RS in the current study was 16.7%, which is quite coherent with numbers found in the literature in similar groups of patients, as several reports described scarring rates of 12.8%–28.6% [ 2 , 10 , 11 ]. Disorders of the lower urinary tract in MMC patients cause secondary VUR, and ultimately renal parenchymal damage with the contribution of UTI.…”

Section: Discussionsupporting

confidence: 92%

“…At birth, most newborns with MMC have a normal UUT. However, the majority will develop deterioration of renal function and bladder wall changes, which start within the first six months of life [ 2 ]. Two main goals in the nephro-urological management of MMC patients, which are preserving renal function and achieving social continence, are sometimes mutually exclusive since, for the UUT, sometimes it is superior to achieve a “wet but safe” rather than a “dry but unsafe” bladder.…”

Section: Discussionmentioning

confidence: 99%

“…The abnormal innervation of the bladder detrusor and sphincter is called a neurogenic bladder (NB). In children with MMC, it causes problems in the bladder storage and emptying functions, which may lead to high intravesical pressures and recurrent urinary tract infections (rUTIs) that, in time, will produce renal scarring and progressive deterioration of the upper urinary tract (UUT) [ 2 ]. These patients form the largest group requiring nephro-urological management, as chronic kidney disease (CKD) and renal failure (RF) affecting even 30%–40% of MMC patients are main causes of their morbidity and mortality [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Miklaszewska

Korohoda

Zachwieja

et al. 2016

IJERPH

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Miklaszewska

Korohoda

Zachwieja

et al. 2016

IJERPH

View full text Add to dashboard Cite

show abstract

“…Abdominal US, including renal assessment, was part of the initial screening protocol for the Zika cohort studies and was normal in the majority of patients. We learned from experience with patients diagnosed with myelomeningocele, to date the most common cause of congenital neurogenic bladder, that the renal US is expected to be normal in newborns but, when high-risk urological indicators are present, urological deterioration is expected to develop after birth and during the first year of life [ 25 ]. When the baseline bladder pressure continuously exceeds 40 cm H 2 O during the filling phase, the upper urinary tract function will be at risk of being impaired [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Neurogenic bladder findings in patients with Congenital Zika Syndrome: A novel condition

et al. 2018

View full text Add to dashboard Cite

IntroductionCongenital Zika Syndrome (CZS) has been associated with microcephaly and other central nervous system abnormalities including areas that have been implicated in the control of the lower urinary tract. As such, this descriptive case series has aimed to investigate whether CZS is linked with neurogenic bladder. Identifying such an association is paramount in the effort to recognize CZS complications that have putative treatment options that could mitigate the impact of CZS in infected children.MethodsFollowing IRB approval, urological assessment was performed in all patients referred to our clinic between June 2016 and May 2017 who presented with confirmed CZS-associated microcephaly. The research protocol consisted of obtaining clinical history, laboratory tests, lower and upper urinary tract ultrasounds, as well as a diagnostic urodynamic evaluation. ZIKA virus infection was previously confirmed by maternal history and positive PCR in babies and mothers. Microcephaly and other central nervous system abnormalities were established based on neurological assessment and associated imaging of the central nervous system (CT head and/or Brain MRI).ResultsTwenty-two consecutive CZS patients were tested and confirmed to have neurogenic bladder. Of the 22 patients assessed, 21 presented with an overactive bladder combined with reduced bladder capacity and elevated detrusor filling pressures. Clinically significant increases in postvoid residual (PVR) were confirmed in 40% of cases while a urinary tract infection (UTI) was identified in 23% of cases.ConclusionNeurogenic bladder, a known treatable health condition, was confirmed in 100% of patients tested in this study, most presenting with high-risk urodynamic patterns known to lead to renal damage when left untreated. Follow up studies are necessary to provide further insight onto long-term disease progression and to investigate the response to standard therapies for neurogenic bladder. Nonetheless, we emphasize the importance of proactive management of neurogenic bladder and prompt referral so as to help mitigate CZS disease burden for patients and their families.

show abstract

“…2018; 28(2):e59680. renal disease (13). Positive outcome of preventive measures such as CIC and anticholinergic therapy has been shown in several studies (14).…”

Section: Discussionmentioning

confidence: 95%

The Incidence of Upper Urinary Tract Deterioration among Iranian Neonates with Spinal Dysraphism

et al. 2018

View full text Add to dashboard Cite

Background: The preemptive management of urinary bladder dysfunction in children with spinal dysraphism has contributed to renal cortical loss and scaring leading to end-stage renal disease, however, there is no consensus regarding the management and follow-up of these patients. Objectives: The present study has been performed to find the incidence of upper urinary tract deterioration in Iranian newborns suffering from spinal dysraphism. Methods: In a prospective study, neonates born with the diagnosis of spinal dysraphism anomalies referred to the Children's Medical Center, Tehran University of Medical Sciences, Iran in 2015 and 2016 were enrolled in the study. Patients were classified into synergic, dyssynergic and complete denervation groups based on the urodynamic studies. All were followed for a year. Results: 55 neonates with age range of 1-60 days were enrolled in the study. Five (9.1%) patients of the dyssynergic and complete denervation group, who were treated using clean intermittent catheterization, were complicated with severe febrile urinary tract infection. Hydrocephalus and vesicourethral reflux were seen in 23 (42%) and 16 (29.1%) patients, respectively. Upper urinary tract deterioration was significantly related to the type of urodynamic pattern (P = 0.02). The risk for upper urinary tract deterioration was highest in the dyssynergic group (seven out of 32 patients), while just one out of 12 patients in the complete denervation group and none in the synergic group experienced upper urinary tract deterioration. Conclusions: This study showed that it may be an acceptable choice to perform urodynamic studies as soon as possible in all newborns diagnosed with spinal dysraphism and categorize them in low and high-risk groups.

show abstract

Estudio del daño renal en el paciente pediátrico con vejiga neurógena y su relación con el patrón de funcionamiento vesical y el tratamiento recibido

Cited by 6 publications

References 21 publications

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

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

Neurogenic bladder findings in patients with Congenital Zika Syndrome: A novel condition

The Incidence of Upper Urinary Tract Deterioration among Iranian Neonates with Spinal Dysraphism

Contact Info

Product

Resources

About