ABSTRACT
INTRODUCTION: To improve compliance with voiding diaries in children with primary monosymptomatic nocturnal enuresis (PMNE), a new modified 3-day weekend frequency-volume chart (FVC) was designed, and the compliance and validity of this modified FVC was evaluated by comparing with the International Children's Continence Society (ICCS) recommended voiding diary. METHODS: A total of 1200 patients with PMNE were enrolled in the study from 13 centers in China and were randomly assigned to record this modified FVC or the ICCS-recommended voiding diary. The primary outcome measure was the compliance, assessed by comparing the completing index and the quality score of diaries between two groups. The secondary outcome measure was the validity, evaluated by comparing the constituent of subtypes, micturition parameters and response rate to desmopressin. RESULTS: Among the 1200 participants enrolled in the study, 447 patients completed the ICCS-recommended voiding diary and 469 completed the modified diary. The diurnal completing index and the quality score of the modified FVC group were better than those of the ICCS group. In addition, there was no significant difference between these two groups in the subtype classification, or in the response rate to desmopressin. CONCLUSIONS: The modified FVC could be applied to obtain the voiding characteristics of children with PMNE as the ICCS-recommended voiding diary does and offers a reasonable and better choice for children with PMNE from the unselected population in the future.
Subject(s)
Nocturnal Enuresis , Child , China , Humans , Nocturnal Enuresis/diagnosis , Nocturnal Enuresis/drug therapy , Prospective StudiesABSTRACT
PURPOSE: Acute nephrotoxicity is a common adverse reaction of tacrolimus therapy; however, its risk factors in pediatric nephrotic syndrome (NS) remain to be evaluated. The objective of this study was to investigate the risk factors and characteristics of tacrolimus-induced acute nephrotoxicity in children with NS. METHODS: Past records of children with NS admitted to our hospital from 2014 to 2018 were reviewed. The incidence and characteristics of nephrotoxicity were analyzed. Multivariate logistic regression analysis was used to identify the risk factors of nephrotoxicity. A clinically applicable risk score was developed and validated. RESULTS: Tacrolimus-induced nephrotoxicity occurred in 25 of 129 patients, 13 patients were grade 1, and the renal function was recovered in 22 patients. Multivariate regression analysis showed that the maximum trough concentrations (C12h) of tacrolimus (OR, 1.48; 95% CI, 1.16 to 1.88; P < 0.001), huaiqihuang granules (OR, 0.095; 95% CI, 0.014 to 0.66; P = 0.017), and diarrhea (OR, 22.00; 95% CI, 1.58 to 306.92; P = 0.022) were independently associated with tacrolimus-induced nephrotoxicity. The maximum C12h were significantly higher in patients with nephrotoxicity (median 9.0 ng/ml) and the cut-off value for acute nephrotoxicity was 6.5 ng/ml. The area under the receiver operating characteristic curve was 0.821 for the proposed model based on the observations used to create the model and 0.817 obtained from k-fold cross-validation. CONCLUSIONS: High trough concentration of tacrolimus and diarrhea can potentiate the risk of tacrolimus-induced acute nephrotoxicity in children with NS, while huaiqihuang granules can protect this condition.
Subject(s)
Immunosuppressive Agents/administration & dosage , Kidney Diseases/chemically induced , Nephrotic Syndrome/drug therapy , Tacrolimus/administration & dosage , Case-Control Studies , Child , Child, Preschool , Diarrhea/epidemiology , Drugs, Chinese Herbal/administration & dosage , Female , Follow-Up Studies , Humans , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/pharmacokinetics , Kidney Diseases/epidemiology , Male , Retrospective Studies , Risk Factors , Tacrolimus/adverse effects , Tacrolimus/pharmacokineticsSubject(s)
Nephritis/complications , Posterior Leukoencephalopathy Syndrome/etiology , Acute Disease , Child , Humans , MaleSubject(s)
Acute Kidney Injury/therapy , Peritoneal Dialysis , Child, Preschool , Female , Humans , Infant , Male , Peritoneal Dialysis/adverse effectsSubject(s)
Paraquat/poisoning , Poisoning/therapy , Child , Hemofiltration , Humans , Male , Treatment OutcomeABSTRACT
A new natural coumarin, angepubebisin (1), and a new furan, angepubefurin (2), together with the five known compounds, umbelliferone, angelol B (3), ulopterol (4), peucedanol (5), and scopoletin, were isolated from the roots of Angelica pubescens Maxim. f. biserrata Shan et Yuan. The structures of angepubebisin (1) and known compounds were determined by spectroscopic methods, including IR, UV, EI-MS, HR-FTICR-MS, 1D-, and 2D-NMR spectral analyses, and angepubefurin (2) was determined by HR-FTICR-MS and X-ray diffraction analyses.
