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1.
International Journal of Pediatrics ; (6): 605-608, 2018.
Article in Chinese | WPRIM | ID: wpr-692553

ABSTRACT

Congenital abnormalities of the kidney and urinary tract (CAKUT)is caused by a variety of reasons,with various phenotypes characterized by congenital anatomic abnormalities of urinary system,and the rate of occurrence is nigh.CAKUT is the main cause of chronic kidney disease in cnildren,and some patients can progress to end-stage renal disease(ESRD).The study of CAKUT in cnildren is of great significance to eugenics,and its pathogenesis is not completely clear.However,many studies have proved that the pathogenesis of CAKUT is related to many factors,such as gene mutation,copy number variation and environment.In addition,the use of color doppler ultrasonography has a significant advantage in the discovery of cnildren's CAKUT.It is the first choice for screening,and then the early corresponding treatment intervention will greatly reduce the degree of damage to the renal function of the cnildren and improve the survival rate of the cnildren,which is of great significance for the prevention of disease.We reviewed the epidemiological studies,etiological studies,color doppler ultrasound screening and interventive treatment of children with CAKUT in recent years,in order to make pediatricians understand children's CAKUT more comprehensively,and take active intervention measures to delay the progress of CKD and orevent the occurrence of ESRD.

2.
Chinese Journal of Urology ; (12): 91-94, 2018.
Article in Chinese | WPRIM | ID: wpr-709487

ABSTRACT

Objective To investigate the timing and scheme of surgical treatment for the concomitant ureteropelvic junction obstruction(UPJO) and congenital abnormalities of the kidney.Methods The clinical data of 155 patients with concomitant UPJO and congenital abnormalities of the kidney from January 2006 to January 2016 was retrospectively analyzed.There were 107 males and 48 females,who aged 6 months to 16 years and 6 months.The average time was 5 years and 9 months old when they received operation.There were 8 cases less than 1 year old.There were 93 cases of UPJO on the left side,54 cases on the right side,and 8 cases on both sides.There were 33 cases with duplication of kidney,19 cases with solitary kidney,and 6 cases with renal dysplasia,6 cases with renal ectopia,12 cases with polycystic kidney disease,and 41 cases with dysplasia;2 cases with renal malrotation.There were 100 cases with symptoms such as fever,abdominal pain,vomiting.5 cases had received Anderson-Hynes pyeloplasty in other hospitals,2 cases received nephrectomy with symptoms did not relieve.4 cases were treated with nephrostomy in other hospital.Children with the repeated clinical symptoms,or renal function decreased significantly,or hydronephrosis progressive to the anteroposterior diameter of more than 30 mm received surgical treatment.Results There were 140 cases received Anderson-Hynes pyeloplasty,and 8 cases received nephrectomy with 5 cases were UPJO side and 3 cases were only abnormalities of the kidney without UPJO.All patients received IVP or ultrasonography postoperative 3-6 months,which showed hydronephrosis improved or no obvious change,and 4 cases were improved obviously.The IVP results showed that 5 patients with renal dysplasia together with UPJO had the renal function improved.There were 128 cases followed up for 12 to 106 months,with an average of 64.5 months.All patients had no clinical symptoms.83 cases were reexamined by IVP or ultrasonography,and hydronephrosis was getting better or no change.Conclusions The patients with concomitant UPJO and congenital abnormalities of the kidney don't need surgery in advance.The best choice for those patients is Anderson-Hynes pyeloplasty.The indication of nephrectomy should be considered carefully.

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