Nefropatía de reflujo y nefropatía cicatricial. Dos entidades tan cercanas pero funcionalmente tan distintas

Nieto, Víctor Manuel García; Zamorano, Margarita Monge; Hernández, Luis Antón; Yanes, María I. Luis; Carreño, Patricia Tejera; Mesa, Teresa Moraleda

doi:10.1016/j.anpedi.2021.08.001

Cited by 2 publications

(3 citation statements)

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“…Рефлюкс-нефропатія на ранніх стадіях розвитку зазвичай не має явних клінічних проявів, а характеризується вогнищевими інтерстиціальними ураженнями, атрофією канальців та нефронів, тобто втратою паренхіми нирки, особливо при розвитку уретерогідронефрозу (рис. 1, 2) [29,43].…”

Section: Reviewsunclassified

“…У разі прогресування рефлюкс-нефропатії формується уретерогідронефротична трансформація, яка супроводжується значними анатомічними, фізіологічними і функціональними порушеннями за рахунок виразної втрати безпосередньо структурних елементів нирки та сечоводу (рис. 3) [29,43].…”

Section: Reviewsunclassified

“…Тобто сечовід виштовхується з міхура трикутним м'язом через ременоподібний м'яз, який під час сечовипускання скорочується та витискає залишки сечі з сечоводу, що запобігає ретроградному струму сечі. Враховуючи, що сечоводи фактично фіксовані один до одного за допомогою колагенових волокон міхурового трикутника, подібне виштовхування сечоводу зі стінки міхура має відбуватися почергово -то справа, то зліва [29,43].…”

Section: оглядиunclassified

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Evolution of views on the functional anatomy of the vesicoureteral segment and etiopathogenetic features of vesicoureteral reflux in children

Savitska,

Konoplitskyi,

Korobko

2024

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Bladder-ureteral reflux is a pathological condition in which there is a periodic and/or permanent retrograde flow of urine from the bladder into the urinary tract due to a malfunction of the anti-reflux mechanism of the vesicoureteral segment. The aim - to study etio-pathological mechanisms of vesicoureteral reflux in children to improve diagnostic and therapeutic tactics. Every year in Ukraine, 3,600-3,700 children with congenital defects of the urinary tract are diagnosed, with 1/3 of the defects occurring in their upper parts. According to statistics, there are 40-50 cases of congenital diseases of the urinary system per 1000 newborns. There are reports that the frequency of vesicoureteral reflux in the general pediatric population exceeds 2%. According to modern data, vesicoureteral reflux accounts for 0.1% to 1.0% of all pathology in the general pediatric population, accounting for 10% of all diseases of the urinary system in hospitalized children. Bladder-ureter is the initial link in the chain of pathological reflux in the urinary tract. The leading importance of the mechanism of the vesicoureteral reflux belongs to the study functional anatomy of the urinary tract as a whole. Bladder-ureteral reflux is most often detected during urination against the background of increased intravesical pressure, but it can occur during any of the stages of the urination cycle. Nephrosclerosis with vesicoureteral reflux is formed in 30-60% of cases, which leads to the development of the terminal stage of chronic renal failure in 25-60% of patients due to a decrease in the functional renal reserve, as an indicator of the compensatory capabilities of the kidneys. Conclusions. Review of literature dataregarding the structure and functional anatomy of the vesicoureteral segment convincingly testifies to the complexity and multi-level organization of its antireflux mechanism. Therefore, any further research in this direction will undoubtedly contribute to a deeper understanding of the normal functioning of this complex anatomical part of the human urinary system, which will allow the development and implementation of the latest physiological treatment methods in the practice of pediatric surgeons. No conflict of interests was declared by the authors.

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Section: Reviewsunclassified

Section: оглядиunclassified

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Evolution of views on the functional anatomy of the vesicoureteral segment and etiopathogenetic features of vesicoureteral reflux in children

Savitska,

Konoplitskyi,

Korobko

2024

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Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort study

Chong

Leow

Yap

et al. 2023

bmjpo

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ObjectivesTo assess the association of clinical factors and investigation results (blood and urine) with imaging abnormalities (ultrasound of the kidneys, ureters and bladder; dimercaptosuccinic acid scan; and/or micturating cystourethrogram) and recurrent urinary tract infections (UTIs) in infants ≤3 months old presenting with their first febrile UTI.MethodsWe conducted a retrospective cohort study of infants ≤3 months old with first febrile UTI admitted from 2010 to 2016. Multivariable logistic regression model was used to analyse the association of imaging abnormalities and recurrent UTI with covariates selected a priori: age at presentation, maximum temperature, duration of illness at presentation, interval between start of antibiotics and fever resolution, C-reactive protein, total white cell count on the full blood count, bacteraemia, white cell count on the urinalysis and non-Escherichia coligrowth in the urine culture (non-E. coliUTI).ResultsThere were 190 infants but 12 did not undergo any imaging. Median age at presentation was 63 days (IQR 41–78). Twenty-four patients had imaging abnormalities. Non-E. coliUTI (adjusted OR (aOR) 5.01, 95% CI 1.65 to 15.24, p=0.004) was independently associated with imaging abnormalities, while bacteraemia (aOR 4.93, 95% CI 1.25 to 19.43, p=0.022) and non-E. coliUTI (aOR 5.06, 95% CI 1.90 to 13.48, p=0.001) were independently associated with recurrent UTI.ConclusionNon-E. coliUTI at the first febrile UTI in infants ≤3 months old may be useful in predicting imaging abnormalities while bacteraemia and non-E. coliUTI may be useful to predict recurrent UTI.

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Nefropatía de reflujo y nefropatía cicatricial. Dos entidades tan cercanas pero funcionalmente tan distintas

Cited by 2 publications

References 31 publications

Evolution of views on the functional anatomy of the vesicoureteral segment and etiopathogenetic features of vesicoureteral reflux in children

Evolution of views on the functional anatomy of the vesicoureteral segment and etiopathogenetic features of vesicoureteral reflux in children

Risk factors for imaging abnormalities after the first febrile urinary tract infection in infants ≤3 months old: a retrospective cohort study

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