Renal preservation in children with neurogenic bladder-sphincter dysfunction followed in a national program.

Autor: Wide P; Department of Experimental and Clinical Medicine, Division of Paediatrics, Linköping University, SE 581 85 Linköping, Sweden. peter.wide@lio.se, Glad Mattsson G, Mattsson S
Jazyk: angličtina
Zdroj: Journal of pediatric urology [J Pediatr Urol] 2012 Apr; Vol. 8 (2), pp. 187-93. Date of Electronic Publication: 2011 Mar 15.
DOI: 10.1016/j.jpurol.2011.02.003
Abstrakt: Purpose: Neurogenic bladder-sphincter dysfunction (NBSD) constitutes the major reason for morbidity in children with spina bifida. The aim of this study was to identify risk factors for renal damage in children with NBSD followed according to the Swedish national guidelines.
Materials and Methods: Records and cystometries from 6 to 16 years (median 11) follow up of 41 consecutive children born 1993-2003 with NBSD were evaluated. The children were divided into a high pressure group (baseline pressure above 30 cmH(2)O at maximal clean intermittent catheterization volume in at least two cystometries) and a low pressure group. Most children (34/41) were followed from birth.
Results: Although renal scarring on DMSA-scintigraphy was found in 5/41 children, all but one had normal renal function. Two already had renal scars on entering the follow-up program at age 2.5 and 3 years. Renal scarring was more frequent in the high pressure group (P < 0.01). Most children with renal scars (4/5) had a combination of low compliant bladder and insufficient compliance with treatment and follow up.
Conclusion: High baseline pressure is confirmed as a risk factor that, in combination with complex social issues, creates a demanding situation for families and professionals. A structured early follow up with treatment compliance effectively prevents renal damage.
(Copyright © 2011 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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