Cicatrizes renais em crianças com refluxo vesicoureteral primário

Macedo, Célia Sperandeo; Riyuzo, Márcia Camegaçava; Bastos, Herculano Dias

doi:10.1590/s0021-75572003000400015

Cited by 7 publications

(4 citation statements)

References 24 publications

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“…Almost all published data found a strong association between severity of VUR and renal scarring. However, our study showed a higher percentage of renal scarring which was in line with the study of Abeysekara et al ., [26] and Macedo et al ., [27] who detected renal scarring among patients with primary VUR in 55.3% and 55.2% of them, respectively. The higher percentages probably should be explained by ineffective treatment of UTI and VUR in that period when patients were diagnosed along with the fact that patients might have had multiple febrile UTIs before their first cystography.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Renal Dysfunction in Adults with Childhood Vesicoureteral Reflux after Long-Term Follow-Up

Bundovska-Kocev¹,

Kuzmanovska²,

Selim³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND:Triad of childhood vesicoureteral reflux (VUR), urinary infection (UTI) and renal scarring might initiate potentially serious consequences that lead to renal dysfunction manifested at the second or third decade of life.AIM:To identify the risk factors predictive for renal dysfunction in adults with primary VUR after long-term follow-up.METHODS:We evaluated the records of 101 children (94.1% female, 5.9% male) at a median age of 5.2 ± 2.3 years (1-12 years), suffering from UTI and VUR. The patients were interviewed after mean 21 years from the first episodes of VUR (8 to 32 years). Renal function was determined from the estimated glomerular filtration rate (eGFR).RESULTS:Renal scarring was detected in 68.3% out of 82 patients and bilateral one in 7.3% patients. Linear regression analysis revealed that presence of proteinuria (B = -33.7, p=0.0001), the greater number of years from VUR diagnosis (B = -1.6, p = 0.002) and renal scarring (B = -14.8, p = 0.005) appeared as independent predictors of reduced global eGFRcreat. The same variables plus microalbuminuria (B = -1.0, p = 0.012) appeared as independent predictors of reduced global eGFRcreat-cys. Bilateral scarring (OR=25.5, p = 0.003) appeared as independent predictor of greater risk for CKD assessed using eGFRcreat while greater number of years from VUR diagnosis (OR = 1.7, p = 0.092), microalbuminuria (OR = 1.3, p = 0.047) and again bilateral scarring (OR = 31.3, p = 0.040) appeared as predictors of risk for CKD assessed using eGFRcreat-cys.CONCLUSION:Identification of those with an increased risk of progression to CKD should be the goal in all patients with childhood VUR. Their systematic follow-up should be till adulthood and older age.

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Section: Discussionmentioning

confidence: 99%

Predictors of Renal Dysfunction in Adults with Childhood Vesicoureteral Reflux after Long-Term Follow-Up

Bundovska-Kocev¹,

Kuzmanovska²,

Selim³

et al. 2019

Open Access Maced J Med Sci

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“…En niños se ha comprobado que el grado del reflujo es un factor de riesgo independiente de la aparición de daño renal 141 , principalmente cuando el reflujo se acompaña con dilatación renal (grado III, IV y V) 142 . La hidronefrosis constituye el estadio final de la obstrucción urinaria 4 .…”

Section: Obstrucción Del Tracto Urinario Inferiorunclassified

Factores pronósticos del tratamiento endoscópico del reflujo vesicoureteral en pacientes con lesión medular

Chamorro¹,

Salinas²,

Bolufer³

et al. 2013

Actas Urológicas Españolas

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A mis Padres AGRADECIMIENTOSEl desarrollo de esta tesis doctoral ha sido mucho mas extenso de lo que en un principio esperaba; desde sus comienzos, con las interminables tardes de recogidas de datos en el Hospital Nacional de Parapléjicos, hasta los últimos coletazos en el diseño de impresión han transcurrido más de 5 años. Durante ese tiempo: he cambiado mi lugar de residencia en múltiples ocasiones, incluido de país durante un tiempo; de trabajo y de otras muchas cosas. A pesar de ello, finalmente conseguí concluir el trabajo, que probablemente no hubiera podido terminar sin la ayuda de toda esa gente que me ha ido apoyando a lo largo de estos años.En primer lugar me gustaría agradecer al servicio de Urología del Hospital Nacional de Parapléjicos: (médicos, enfermeras, auxiliares y personal administrativo) porque sin ellos nunca habría sido posible realizar esta Tesis, además, por su importante labor asistencial, mejorando cada día la vida de los pacientes con lesión medular.Mi mas sincera gratitud a mis directores de tesis: Al Dr. Virseda, por su estímulo constante durante todo este tiempo y por su gran conocimiento que ha hecho realidad este proyecto, siempre demostrándome que en definitiva la investigación es una manera igual de importante, para ayudar a nuestros pacientes mejorando y alargando su vida.Al Dr. Salinas por su gran aportación continua a la urología funcional, incansable en su insistencia en que concluyera el trabajo, asentando las bases en la que está apoyado todo nuestro estudio.Al Dr. Esteban por el inagotable entusiasmo, que pone cada día en todo lo que realiza, haciendo que este proyecto saliera adelante, luchando porque la investigación en urología funcional siga adelante convirtiendo este campo de la urología en uno de los mas activos actualmente.Me gustaría agradecer al servicio de Urología del Hospital Virgen de la Salud: por su apoyo continuo, ayudándome a crecer como urólogo. De todos he aprendido, y han sido unos de los mejores años de mi vida. En especial quiero agradecer a la Dra. Buendía haber creído siempre en mí, apoyando todos los proyectos que me han ido surgiendo en todos estos años, enseñándome con paciencia todo lo que se. Gracias.También me gustaría agradecer a todo mi equipo en la Fundación Jimenez Díaz, por no ponerme nunca obstáculos para concluir esta tesis, robándoles algunas horas de trabajo que probablemente hayan tenido que realizar ellos.A mi familia, por su ejemplo en el trabajo:A mi madre, Amparo, por su inagotable insistencia, probablemente el motor más importante para que este trabajo esté concluido.A mi padre, Ricardo, por haberme ayudado en la maquetación de este proyecto, en un momento en el que el Word pudo mas que yo y estuve a punto de tirar la toalla.A mi hermana María, por el tiempo que esta tesis le haya podido robar, siempre sacándome una sonrisa en cualquier momento.A Elena: por haberme acompañado siempre, no dejándome nunca solo, orientándome cuando me perdía, y sobre todo haciendo que los momentos duros fueran mucho más fáciles.Muchas gracias.

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“…If not early and appropriately treated, such a condition may result in permanent renal scarring with sequels of hypertension and chronic renal failure (3) -the most serious long term complications (4) . Approximately 6% to 13% of the children with renal scarring will develop arterial hypertension, and in 5% to 10% of cases, renal scarring will cause chronic renal failure (5) . Besides late diagnosis (with associated late therapeutics), age under one year, presence of vesicoureteral reflux (VUR) particularly with high degree, presence of obstructive lesions and occurrence of recurrent APNs, constitute factors associated with the development of permanent renal damage (1,6) .…”

Section: Introductionmentioning

confidence: 99%

Prevalência de pielonefrite aguda e incidência de cicatriz renal em crianças menores de dois anos de idade com infecção do trato urinário avaliadas por cintilografia renal com 99mTc-DMSA: a experiência de um hospital universitário

et al. 2013

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Tc-DMSA renal scintigraphy in a university hospital in Rio Grande do Sul between 2006 and 2009 were reviewed to investigate acute pyelonephritis/renal scarring. Additionally, the presence of vesicoureteral reflux, early use of antibiotics, and comorbidities were investigated on electronic records. The sample size calculation was based on a systematic review study and obtained a minimum of 147 patients. Patients whose electronic records were not available were excluded. Results: One hundred and fifty-seven children met the inclusion criteria; among them 48 had acute pyelonephritis and 8 of these had renal scars. Neither age nor sex presented any significant association with acute pyelonephritis (p = 0.405 and p = 0.124, respectively). No statistical significance was observed in the association between vesicoureteral reflux and acute pyelonephritis (p = 1.0) and other comorbidities (p = 0.470), and in relation to early use of antibiotics with acute pyelonephritis (p = 0.130) and renal scarring (p = 0.720). Conclusion: The frequencies found in the present study for acute pyelonephritis/renal scarring are in agreement with the results reported by most studies in the literature. Keywords: Pyelonephritis; DMSA; Scar.Objetivo: Calcular as frequências de pielonefrite aguda e cicatriz renal em pacientes menores de dois anos com cintilografia renal com 99m Tc-DMSA com primeiro quadro de infecção do trato urinário em hospital universitário brasileiro, comparando com dados da literatura internacional. Materiais e Métodos: Foram revisados laudos cintilográficos de crianças menores de dois anos de idade que realizaram cintilografia renal com 99m Tc-DMSA em um hospital universitário no Rio Grande do Sul, entre 2006 e 2009, para pesquisa de pielonefrite aguda/cicatriz renal. Revisaram-se a presença de refluxo vesicoureteral, o uso precoce de antibiótico, e a presença de comorbidades que constassem nos prontuários eletrônicos. Calculou-se a amostra com base num estudo de revisão sistemática e obteve-se um mínimo de 147 pacientes. Excluíram-se pacientes sem registro eletrônico. Resultados: Cento e cinquenta e sete crianças preencheram critérios de inclusão do estudo, 48 tiveram pielonefrite aguda e 8 destas apresentaram cicatriz renal. Nem a idade nem o gênero dos pacientes apresentaram associação significativa com pielonefrite aguda (p = 0,405 e p = 0,124, respectivamente). Não houve diferença estatística nas associações de refluxo vesicoureteral e pielonefrite aguda (p = 1,0) e outras comorbidades (p = 0,470) e em relação ao uso precoce de antibiótico com pielonefrite aguda (p = 0,130) e cicatriz renal (p = 0,720). Conclusão: As frequências de pielonefrite aguda e cicatriz renal obtidas concordam com os resultados da maioria dos estudos publicados. Unitermos: Pielonefrite; DMSA; Cicatriz. Berdichevski EH, Mattos SG, Bezerra S, Vilas ER, Baldisserotto M. Prevalence of acute pyelonephritis and incidence of renal scarring in children under the age of two with urinary tract infection evaluated by 99m Tc-DMSA renal scintigraphy: the...

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Cicatrizes renais em crianças com refluxo vesicoureteral primário

Abstract: Fever and female sex were risk factors for the presence of renal scars, mainly in the dilated vesicoureteral reflux. The high incidence of renal scars in this study may be related to delayed diagnosis of vesicoureteral reflux.

Cited by 7 publications

References 24 publications

Predictors of Renal Dysfunction in Adults with Childhood Vesicoureteral Reflux after Long-Term Follow-Up

Predictors of Renal Dysfunction in Adults with Childhood Vesicoureteral Reflux after Long-Term Follow-Up

Factores pronósticos del tratamiento endoscópico del reflujo vesicoureteral en pacientes con lesión medular

Prevalência de pielonefrite aguda e incidência de cicatriz renal em crianças menores de dois anos de idade com infecção do trato urinário avaliadas por cintilografia renal com 99mTc-DMSA: a experiência de um hospital universitário

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