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- Abrahamsson, Kate, 1959, et al.
(författare)
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Estimation of renal function in children and adolescents with spinal dysraphism.
- 2008
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Ingår i: The Journal of urology. - : Ovid Technologies (Wolters Kluwer Health). - 1527-3792 .- 0022-5347. ; 179:6, s. 2407-9
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: In children with spinal dysraphism such as myelomeningocele the relation between muscle mass and body composition varies considerably. Therefore, it is difficult to evaluate the relevance of renal function assessments done with serum creatinine. Since serum cystatin C has been suggested to be independent of body size and composition, this evaluation was compared to chromium(51) edetic acid clearance. MATERIALS AND METHODS: Simultaneous measurements of cystatin C and chromium(51) edetic acid clearance were performed prospectively in 65 patients 2 to 19 years old with spinal dysraphism. RESULTS: Cystatin C values were within the normal range in all patients, while chromium(51) edetic acid clearance was reduced in 10. A significant relation was seen. CONCLUSIONS: Using chromium(51) edetic acid clearance as a gold standard, children with spinal dysraphism and slightly to moderately reduced renal function may remain undiagnosed if cystatin C is used for evaluation.
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| 2. |
- Abrahamsson, Kate, 1959, et al.
(författare)
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Ultrasonography and renography to visualize upper urinary tract in children with meningomyelocele - A prospective study.
- 2012
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Ingår i: Journal of pediatric urology. - : Elsevier BV. - 1873-4898 .- 1477-5131. ; 8:2, s. 174-176
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Ultrasonography (US) is commonly used to visualize the upper urinary tract in children and adolescents with meningomyelocele (MMC). The aim of this investigation was to prospectively evaluate US in those with spinal angulation or obesity and compare it to the corresponding results obtained by mercaptoacetyltriglycine renography. PATIENTS AND METHODS: Twenty-five children and adolescents with MMC and pronounced angulation of the spine or obesity, were prospectively investigated with both US and renography during the period 2006 to 2008. RESULTS: In 13 (52%) patients the kidneys could not be fully evaluated; in 4 (16%) neither renal size nor pelvic dilation, in 12 (48%) renal length and in 5 (20%) dilation was not accessible. In 23 individuals where dilatation could be evaluated uni- or bilaterally, US was compared to OEE% (%outflow excretion efficiency) at renography. In 1 of these individuals there was normal OEE% while slight dilatation on US was noticed. In 2/15 individuals, split function at renography did not correlate with renal length on US. CONCLUSION: Severe spinal angulation and obesity in individuals with MMC reduced the possibility to evaluate the urinary tract by US. However, it seems that renography could be a reliable alternative to evaluate renal condition in those patients where US is insufficient.
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| 3. |
- Andersson, Lena, 1980, et al.
(författare)
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Urinary proteins in children with urinary tract infection
- 2009
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Ingår i: Pediatric Nephrology. - : Springer Science and Business Media LLC. - 0931-041X .- 1432-198X. ; 24:8, s. 1533-1538
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Tidskriftsartikel (refereegranskat)abstract
- Abstract The aim of this study was to test our hypothesis that the urinary excretion of C-reactive protein (CRP), alpha 1-microglobulin (A1M), retinol-binding protein (RBP) and Clara cell protein (CC16) is increased in children with urinary tract infection (UTI) and relates to renal damage as measured by acute dimercaptosuccinic acid (DMSA) scintigraphy. Fifty-two children <2 years of age with UTI were enrolled in the study, 44 of whom were febrile. The control group consisted of 23 patients with non-UTI infection and elevated serum CRP (s-CRP) levels. Thirty-six patients had abnormal DMSA uptake, classified as mild, moderate or severe damage (DMSA class 1, 2, 3, respectively). There was a significant association between DMSA class and the excretion of urinary RBP (u-RBP) and u-CC16. There was also a significant difference in u-CRP levels between children with UTI and control children with non-UTI infections, although u-CRP excretion was not significantly correlated to DMSA class. In conclusion, the urinary excretion of the low-molecular-weight proteins RBP and CC16 showed a strong association with uptake defects on renal DMSA scans. The urinary level of CRP seems to distinguish between children with UTI and other febrile conditions. A combination of these biomarkers may be useful in the clinical assessment of children with UTI.
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| 4. |
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| 5. |
- Bartik, Zsuzsa, et al.
(författare)
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Hereditary Vesicoureteral Reflux: A Study of 66 Families
- 2015
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Ingår i: Open Journal of Pediatrics. - : Scientific Research Publishing, Inc.. - 2160-8741 .- 2160-8776. ; 2015:5, s. 304-313
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: We studied the inheritance pattern, clinical features and outcome in children with vesicoureteral reflux (VUR). Characteristics of known familial VUR cases were also compared with those of sporadic VUR. Material and Methods: 726 patients were treated for VUR between 1990-2004. The families were contacted by letter inquiring if other members of the family were affected. The phenotype of all cases (familial and non-familial) was characterized in terms of presenting symptoms, reflux grade, recurrent urinary tract infections, kidney damage, and the natural course of reflux. Results: The response rate was 79%. A total of 99 individuals (22%) reported relatives with VUR. Since some of the 99 index cases belonged to the same family, the total number of families was ultimately 66. The distribution of relatives with VUR was: 38 siblings, 20 parents (15 mothers), 19 cousins, 15 aunts/uncles and 12 grandparents. The phenotype of VUR did not differ between familial and non-familial cases. However, VUR among relatives was of milder grade than index and sporadic cases. Conclusions: The proportion of hereditary reflux in our material was lower than in other studies (22%). We found a strong overrepresentation of maternal transmission of reflux. Severity of the disease did not differ between familial and non-familial VUR.
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| 6. |
- Brandström, Per, 1959, et al.
(författare)
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Njurskada hos barn randomiserade till profylax, endoskopisk injektion eller observation. Resultat från Svenska Refluxstudien : Renal damage in childen randomized to prophylaxis, endoscopic injection or surveillance. Results from the Swedixh Reflux Study.
- 2009
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Ingår i: Konferensprogram, 43rd Annual Scientific Meeting of the European Society for Paediatric Nephrology. 2-5 september 2009, Birmingham, England..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives and Study: To compare the risk of renal damage in children with dilated vesicoureteral reflux (VUR) grade III-IV randomized to antibiotic prophylaxis, endoscopic injection or surveillance. Methods: Children 1-2 years of age with VUR III-IV were randomized to one of the three treatment arms. Voiding cystourethrography (VCUG) and DMSA scintigraphy were performed at entry and after 2 years. End points were febrile urinary tract infections (UTI), development of renal damage and VUR. Abnormality on DMSA was defined as a focal defect with split function of 45% or more (class 1), split funtion 40-44% irrespective of focal defects (class 2), or split funtion <40% (class 3). Progress of damage was defined as a decrease in split function of 3% or more, and new damage reduced uptake in a previously normal area of the kidney. Results: The included 203 children were allocated to prophylaxis (n=69), endoscopic treatment (n=66), and surveillance (n=68). At entry 123 patients had an abnormal DMSA; 18 of these were bilateral. At the 2 year DMSA, 23 showed progress of damage with no difference between treatment arms. Progress of renal damage was seen in 12 of 49 (24%) children with febrile recurrences as compared to 11 of 154 (7%) in those without febrile recurrences (p<0.001). New renal damage was seen in 10 of 49 (20%) children with febrile recurrences as compared to 4 of 154(2.5%) of those without febrile recurrences (p<0.0001). Conclusions: New damage occurred significantly more often in the surveillance and endoscopic groups than in the prophylaxis group. There was no difference in progress of renal damage between the three treatment arms. The risk of progress of renal damage as well as development of new renal damage was significantly correlated to the rate of recurrent febrile UTIs. In this study of small children with VUR grade III-IV antibacterial prophylaxis reduced the risk of new renal damage and recurrent UTI.
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| 7. |
- Brandström, Per, 1959, et al.
(författare)
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Renal damage in children randomized to prophylaxis, endoscopic injection, or surveillance
- 2010
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Ingår i: European Society for Paediatric Urology Annual Meeting, 28 april-1 maj 2010, Antalya, Turkiet.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- PURPOSE To compare the development of new renal damage in small children with dilating vesicoureteral reflux randomly allocated to antibiotic prophylaxis, endoscopic treatment or surveillance (control group). MATERIAL AND METHODS Included were 203 children, 128 girls and 75 boys, aged 1 to less than 2 years with reflux grade III to IV. Voiding cystourethrography and 99mTcdimercaptosuccinic acid scintigraphy were performed before randomization and after 2 years. Febrile urinary tract infections were recorded during the follow-up. Data analysis was performed according to the intention-to-treat principle. RESULTS New renal damage in a previously unscarred area was seen in 15 children, 13 girls and 2 boys. Eight of these 13 girls were in the surveillance, 5 in the endoscopic, and none in the prophylaxis group (p=0.0155). New damage was seen more often in children with (11/49, 22%) than without (4/152, 3%) febrile recurrence (p<0.0001). CONCLUSIONS In boys the rate of new renal damage was low. It was significantly higher in girls, being most frequent in the surveillance (control) group. There was also a strong association between febrile UTI recurrence and development of new renal damage in girls.
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| 8. |
- Brandström, Per, 1959, et al.
(författare)
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The Swedish Reflux Trial in Children: I. Study Design and Study Population Characteristics
- 2010
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Ingår i: Journal of Urology. - : Ovid Technologies (Wolters Kluwer Health). - 0022-5347 .- 1527-3792. ; 184:1, s. 274-279
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Konferensbidrag (refereegranskat)abstract
- Purpose: We compared the rates of febrile urinary tract infection, kidney damage and reflux resolution in children with vesicoureteral reflux treated in 3 ways, including antibiotic prophylaxis, endoscopic therapy and surveillance with antibiotics only for symptomatic urinary tract infection. Materials and Methods: Children 1 to younger than 2 years with grade reflux were recruited into this prospective, open, randomized, controlled, multi-center study and followed for 2 years after randomization. The main study end points were recurrent febrile urinary tract infection, renal status on dimercaptosuccinic acid scintigraphy and reflux status. Outcomes were analyzed by the intent to treat principle. Results: During a 6-year period 128 girls and 75 boys entered the study. In 96% of cases reflux was detected after urinary tract infection. The randomization procedure was successful and resulted in 3 groups matched for relevant factors. Recruitment was slower than anticipated but after patients were entered adherence to the protocol was good. Of the children 93% were followed for the intended 2 years without a treatment arm change. All except 2 patients completed 2-year followup scintigraphy. Conclusions: Recruitment was difficult but a substantial number of children were entered and randomly assigned to 3 groups with similar basic characteristics. Good adherence to the protocol made it possible to address the central study questions.
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| 9. |
- Brandström, Per, 1959, et al.
(författare)
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The Swedish Reflux Trial in Children: IV. Renal Damage.
- 2010
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Ingår i: The Journal of urology. - : Ovid Technologies (Wolters Kluwer Health). - 1527-3792 .- 0022-5347. ; 184:1, s. 292-297
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: We compared the development of new renal damage in small children with dilating vesicoureteral reflux randomly allocated to antibiotic prophylaxis, endoscopic treatment or surveillance as the control group. MATERIALS AND METHODS: Included in the study were 128 girls and 75 boys 1 to younger than 2 years with grade III-IV reflux. Voiding cystourethrography and dimercapto-succinic acid scintigraphy were done before randomization and after 2 years. Febrile urinary tract infections were recorded during followup. Data analysis was done by the intent to treat principle. RESULTS: New renal damage in a previously unscarred area was seen in 13 girls and 2 boys. Eight of the 13 girls were on surveillance, 5 received endoscopic therapy and none were on prophylaxis (p = 0.0155). New damage was more common in children with than without febrile recurrence (11 of 49 or 22% vs 4 of 152 or 3%, p <0.0001). CONCLUSIONS: In boys the rate of new renal damage was low. It was significantly higher in girls and most common in the control surveillance group. There was also a strong association between recurrent febrile UTIs and new renal damage in girls.
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| 10. |
- Ciofetta, Gianclaudio, et al.
(författare)
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Guidelines for lung scintigraphy in children.
- 2007
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Ingår i: European journal of nuclear medicine and molecular imaging. - : Springer Science and Business Media LLC. - 1619-7070 .- 1619-7089. ; 34:9, s. 1518-26
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this set of guidelines is to help the nuclear medicine practitioner perform a good quality lung isotope scan. The indications for the test are summarised. The different radiopharmaceuticals used for the ventilation and the perfusion studies, the technique for their administration, the dosimetry, the acquisition of the images, the processing and the display of the images are discussed in detail. The issue of whether a perfusion-only lung scan is sufficient or whether a full ventilation-perfusion study is necessary is also addressed. The document contains a comprehensive list of references and some web site addresses which may be of further assistance.
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