The use of urinary osmolality to evaluate postoperative renal function in children with ureteropelvic junction obstruction.

Autor:	Pérez-Etchepare Figueroa EL; Pediatric Surgery Department, Nuestra Señora de Candelaria University Hospital, Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife), Carretera del Rosario 145, Santa Cruz de Tenerife, CP 38010, Spain. Electronic address: perezetchepare@gmail.com., Moraleda Mesa T; Pediatric Nephrology Department, Nuestra Señora de Candelaria University Hospital, Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife), Carretera del Rosario 145, Santa Cruz de Tenerife, CP 38010, Spain. Electronic address: tmoraleda91@gmail.com., Hernández Rodríguez RA; Pediatric Surgery Department, Nuestra Señora de Candelaria University Hospital, Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife), Carretera del Rosario 145, Santa Cruz de Tenerife, CP 38010, Spain. Electronic address: raquelhache@hotmail.com., Rosell Echevarría MJ; Pediatric Surgery Department, Nuestra Señora de Candelaria University Hospital, Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife), Carretera del Rosario 145, Santa Cruz de Tenerife, CP 38010, Spain. Electronic address: dra.mariajoserosell@gmail.com., Tejera Carreño P; Pediatric Nephrology Department, Nuestra Señora de Candelaria University Hospital, Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife), Carretera del Rosario 145, Santa Cruz de Tenerife, CP 38010, Spain. Electronic address: patriciatejcar@gmail.com., Luis Yanes MI; Pediatric Nephrology Department, Nuestra Señora de Candelaria University Hospital, Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife), Carretera del Rosario 145, Santa Cruz de Tenerife, CP 38010, Spain. Electronic address: mabelyanes2@gmail.com., Monge Zamorano M; Pediatric Nephrology Department, Nuestra Señora de Candelaria University Hospital, Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife), Carretera del Rosario 145, Santa Cruz de Tenerife, CP 38010, Spain. Electronic address: mongemargarita@gmail.com., García Nieto VM; Pediatric Nephrology Department, Nuestra Señora de Candelaria University Hospital, Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife), Carretera del Rosario 145, Santa Cruz de Tenerife, CP 38010, Spain. Electronic address: vgarcianieto@gmail.com.
Jazyk:	angličtina
Zdroj:	Journal of pediatric urology [J Pediatr Urol] 2021 Aug; Vol. 17 (4), pp. 513.e1-513.e7. Date of Electronic Publication: 2021 Jun 04.
DOI:	10.1016/j.jpurol.2021.05.025
Abstrakt:	Introduction: Split renal function measured in a diuretic renogram is the most popular tool in initial assessment and follow-up of patients with ureteropelvic junction obstruction (UPJO). This study aims to evaluate the use of maximum urinary osmolality after desmopressin administration (DDAVP) to detect renal dysfunction. Patients and Methods: 56 children (33 males, 23 females) diagnosed with UPJO underwent quantification of the maximum urinary osmolality (UOsm) at diagnosis. 41 of these children (28 males, 13 females) underwent surgery for UPJO and quantification of the UOsm before and after the surgical intervention (six to 18 months postoperatively) and were included in this longitudinal study. Results and Discussion: At diagnosis, UOsm measured after desmopressin administration was abnormal in 64% of patients. After surgical intervention, this rate decreased to 53%. At initial assessment, high creatinine levels were found in 32% of infants younger than one year of age. Albumin/Cr and NAG/Cr ratios were elevated in 12% and 7% of cases, respectively. After surgical intervention, an improvement in the NAG/creatinine ratio and creatinine levels was observed. Preoperative split renal function of the affected kidney was less than 45% in 39% of cases, normal in 44%, and greater than 55% in 17%; in these three subgroups, no differences in renal function markers were found. Conclusions: The most sensitive parameter to detect alterations in renal function in children with UPJO is the UOsm and, therefore, the most useful in the follow-up after surgery. No correlation was found between other functional and morphological parameters obtained on renal ultrasound and renogram. Competing Interests: Conflicts of interest None. (Copyright © 2021 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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