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Renal function in children with congenital neurogenic bladder
Olandoski, Karen Previdi; Koch, Vera; Trigo-Rocha, Flavio Eduardo.
  • Olandoski, Karen Previdi; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clinicas. Instituto da Criança. São Paulo. BR
  • Koch, Vera; Universidade de São Paulo. Faculdade de Medicina. Hospital das Clinicas. Instituto da Criança. São Paulo. BR
  • Trigo-Rocha, Flavio Eduardo; Universidade de São Paulo. Faculdade de Medicina. Hospital da Clinicas. São Paulo. BR
Clinics ; 66(2): 189-195, 2011. graf, tab
Artigo em Inglês | LILACS | ID: lil-581500
ABSTRACT

AIMS:

Preservation of renal function in children with congenital neurogenic bladder is an important goal of treatment for the disease. This study analyzed the evolution of renal function in patients with congenital neurogenic bladder.

METHODS:

We reviewed the records of 58 pediatric patients with respect to the following attributes gender, age, etiology of neurogenic bladder, reason for referral, medical/surgical management, episodes of treated urinary tract infections, urodynamics, DMSA scintigraphy, weight, height, blood pressure, glomerular filtration rate, microalbuminuria and metabolic acidosis. Statistical analysis was performed, adopting the 5 percent significance level.

RESULTS:

The mean age at presentation was 4.2 ± 3.5 years. Myelomeningocele was the most frequent etiology (71.4 percent). Recurrent urinary tract infection was the reason for referral in 82.8 percent of the patients. Recurrent urinary tract infections were diagnosed in 84.5 percent of the patients initially; 83.7 percent of those patients experienced improvement during follow-up. The initial mean glomerular filtration rate was 146.7 ± 70.1 mL/1.73 m²/min, and the final mean was 193.6 ± 93.6 mL/1.73 m²/min, p = 0.0004. Microalbuminuria was diagnosed in 54.1 percent of the patients initially and in 69 percent in the final evaluation. Metabolic acidosis was present in 19 percent of the patients initially and in 32.8 percent in the final assessment.

CONCLUSIONS:

Patient referral to a pediatric nephrologist was late. A reduction in the number of urinary tract infections was observed with adequate treatment, but microalbuminuria and metabolic acidosis occurred frequently despite adequate management.
Assuntos


Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Bexiga Urinaria Neurogênica / Taxa de Filtração Glomerular / Túbulos Renais Tipo de estudo: Estudo de etiologia Limite: Adolescente / Criança / Criança, pré-escolar / Feminino / Humanos / Lactente / Masculino / Recém-Nascido Idioma: Inglês Revista: Clinics Assunto da revista: Medicina Ano de publicação: 2011 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Universidade de São Paulo/BR

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Texto completo: DisponíveL Índice: LILACS (Américas) Assunto principal: Bexiga Urinaria Neurogênica / Taxa de Filtração Glomerular / Túbulos Renais Tipo de estudo: Estudo de etiologia Limite: Adolescente / Criança / Criança, pré-escolar / Feminino / Humanos / Lactente / Masculino / Recém-Nascido Idioma: Inglês Revista: Clinics Assunto da revista: Medicina Ano de publicação: 2011 Tipo de documento: Artigo País de afiliação: Brasil Instituição/País de afiliação: Universidade de São Paulo/BR