Non-neurogenic bladder and chronic renal insufficiency in childhood
| Autor: | Despina E. Varlam, Jürgen Dippell |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Nephrology
Adult medicine.medical_specialty Adolescent Urinary system Urology urologic and male genital diseases Vesicoureteral reflux Recurrence Internal medicine medicine Intermittent catheterisation Humans Child Upper urinary tract Ultrasonography Kidney business.industry Urinary retention Urinary Bladder Diseases Urinary Retention medicine.disease Magnetic Resonance Imaging Surgery Urodynamics medicine.anatomical_structure Treatment Outcome Child Preschool Creatinine Pediatrics Perinatology and Child Health Urinary Tract Infections Kidney Failure Chronic Female medicine.symptom business Voiding Disorders |
| Zdroj: | Pediatric nephrology (Berlin, Germany). 9(1) |
| ISSN: | 0931-041X |
| Popis: | Functional voiding disorders and urinary tract infections are common in childhood, but are usually not accompanied by upper urinary tract deterioration. Nevertheless a small group of children remain at risk of developing chronic renal insufficiency (CRI). Clinically these children present day and night wetting. The most important parameter, however, is urinary retention which is reflected by an abnormal voiding pattern in the uroflow curve. After ruling out patients with neurogenic or anatomical disorders, nine girls with psychogenic urine retention were observed for 5 years. Terminal renal insufficiency was seen in one, CRI in five patients and in three patients the kidney function could be maintained, but they all had severe scarring of at least one kidney. Furthermore, all revealed a dilation of the bladder and the upper urinary tract. Vesicoureteral reflux occurred in six and obstruction of the ureterovesical junction in three patients. Two girls underwent repeated reflux surgery resulting in a rapid deterioration of renal function. Three patients developed hypertension and one had a hypertensive crisis with microangiopathic anaemia and acute renal failure. Psychogenic disorders and problematic family settings were observed in all cases. Bladder training, transitory suprapubic catheters, intermittent catheterisation, medication and psychotherapy can avoid severe kidney damage and achieve a stabilisation of renal function. It is important to bear this syndrome in mind when evaluating girls with asymptomatic bacteriuria and urinary retention. |
| Databáze: | OpenAIRE |
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