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

Miklaszewska, Monika; Korohoda, Przemysław; Zachwieja, Katarzyna; Wolnicki, Michał; Mizerska-Wasiak, Małgorzata; Drożdż, Dorota; Pietrzyk, Jacek A

doi:10.3390/ijerph13090876

Cited by 3 publications

(13 citation statements)

References 27 publications

(41 reference statements)

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“…Two studies included 36 children with neurogenic bladder after spinal cord injury (SCI) . Mean range of age was 0‐15.3 years . Mean follow‐up ranged from 0.5 to 11 years .…”

Section: Resultsmentioning

confidence: 99%

“…Mean follow‐up ranged from 0.5 to 11 years . In this young population, 951 (61%) were receiving treatment for their NLUTD at the time of the inclusion in 16/28 studies . Of those, 635 (67%) were managed by intermittent catheterization (IC) (see Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Considering the evaluation of kidney function using laboratory tests, only two studies reported a serum creatinine >1 mg/dL (88.42 μmol/L) in three and two young patients, respectively . Two other authors reported the mean level of GFR ranging from 67.5 to 161.25 mL/min …”

Section: Resultsmentioning

confidence: 99%

“…33,53 Mean range of age was 0-15.3 years. 23,40 Mean follow-up ranged from 0.5 to 11 years. 36,44 In this young population, 951 (61%) were receiving treatment for their NLUTD at the time of the inclusion in 16/28 studies.…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

“…36,44 In this young population, 951 (61%) were receiving treatment for their NLUTD at the time of the inclusion in 16/28 studies. 17,18,22,23,26,31,33,35,36,38,40,49,51,[54][55][56] Of those, 635 (67%) were managed by intermittent catheterization (IC) (see Table 1). In 21/49 studies, adults affected by the following neurological diseases were included: traumatic SCI (n = 1210, 59.2%), multiple sclerosis (MS) (n = 706, 34.5%), spina bifida (n = 112, 5.5%).…”

Section: Study and Patient Characteristicsmentioning

confidence: 99%

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Value of urodynamic findings in predicting upper urinary tract damage in neuro‐urological patients: A systematic review

Musco

Padilla‐Fernández

Popolo

et al. 2018

Neurourology and Urodynamics

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Patients with SB and SCI have a higher risk of developing UUTD (mainly reported as HDN) compared to those with MS. Reduced compliance and high DLPP were major risk factors for UUTD. Although our findings clarify the mandatory role of urodynamics in the management of NLUTD, standardization and better implementation of assessments in daily practice may further improve outcomes of neuro-urological patients based on objective measurements, that is, urodynamics.

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“…Two studies included 36 children with neurogenic bladder after spinal cord injury (SCI) . Mean range of age was 0‐15.3 years . Mean follow‐up ranged from 0.5 to 11 years .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Study and Patient Characteristicsmentioning

confidence: 99%

Section: Study and Patient Characteristicsmentioning

confidence: 99%

See 3 more Smart Citations

Value of urodynamic findings in predicting upper urinary tract damage in neuro‐urological patients: A systematic review

Musco

Padilla‐Fernández

Popolo

et al. 2018

Neurourology and Urodynamics

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Update on bone fragility in spina bifida

Marreiros¹

2018

PRM

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BACKGROUND CONTEXT: Patients with spina bifida (SB) are at risk for pathological fractures and low bone mineral density (BMD). PURPOSE AND METHODS: This article reviews the literature and provides a comprehensive overview of how the characteristics of SB and its associated comorbidities intersect with bone fragility to identify possible pathophysiological mechanisms of fractures and low BMD. RESULTS: Bone fragility occurs early in the life of patients with SB as a result of a disturbance that determines changes in bone shape, quantity, and quality, as poor mineralization reduces bone stiffness. Bone fragility in SB occurs due to local and systemic factors and may be considered a state of impaired bone quality of multifactorial aetiology, with complex interacting influences of neurological, metabolic, and endocrinological origins and the presence of smaller bones. Bone fragility should be evaluated globally according to skeletal age and Tanner staging. The phases of the evolution of Charcot joints seem to intercept the evolution of epiphyseal fractures. Charcot arthropathy in SB may be initiated by the occurrence of repetitive trauma and fractures in epiphyseal and subepiphyseal regions, where there is a deficit of bone mineralization and greater bone mass deficits. CONCLUSION: Bone fragility in MMC potentially has a multifactorial neuro-endocrinological-metabolic-renal dimension, with smaller bones, lower bone mass, and mineralization deficits affecting bone strength.

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A two-centre study of risk factors involved in renal deterioration in neurogenic bladder in children after myelomeningocele

Bagińska¹,

Miklaszewska²,

Liszewska³

et al. 2019

polp

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Introduction: Myelomeningocele (MMC) is the first cause of neurogenic bladder in children. Adequate nephrourological management is crucial to prevent renal damage and bladder dysfunction. In the last decade, the prognosis of MMC children has dramatically improved, but can we do better? We wanted to detect risk factors involved in renal deterioration in MMC patients. Material and methods: This retrospective analysis was based on 178 children with MMC (99 girls and 79 boys) from two Polish hospitals, in Bialystok and Cracow. The children's medical records were analysed to determine sex, age, and kidney and urinary tract ultrasound, voiding cystourethrogram, and urodynamic findings. The number of clean intermittent catheterisations performed per day, cystatin C, serum creatinine, urea, and glomerular filtration rate (GFR) Schwartz were also recorded. The Hoffer scale was used to assess MMC children's motor function. Results: Of the 111 from Bialystok and 67 children from Cracow, with a median age of nine years, 45 (25%) had vesicoureteral reflux. The most common urodynamic finding was overactive bladder with a prevalence of 59%. There were statistically significant differences between girls and boys, including the presence of reflux, increased echogenicity of the kidneys' parenchyma in ultrasound examination and cystometric capacity in urodynamic study. There were statistically significant differences between the Hoffer scale groups, including GFR Schwartz. The number of performed urodynamics correlated with GFR Schwartz, serum concentrations of cystatin C, and creatinine. Conclusions: Potential risk factors of renal deterioration in children with MMC are abnormalities in ultrasound, the presence of high-grade vesicoureteral reflux in cystogram, increased bladder pressure on urodynamics, hyperfiltration, and increased levels of cystatin C. Urodynamic evaluation may play a role in the management of children with MMC by identifying those with increased bladder pressures. Frequent urodynamic assessment may contribute to prevention of renal function in children with MMC.

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

Cited by 3 publications

References 27 publications

Value of urodynamic findings in predicting upper urinary tract damage in neuro‐urological patients: A systematic review

Value of urodynamic findings in predicting upper urinary tract damage in neuro‐urological patients: A systematic review

Update on bone fragility in spina bifida

A two-centre study of risk factors involved in renal deterioration in neurogenic bladder in children after myelomeningocele

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