Konjenital böbrek ve üriner sistem anomalileri: Tek merkez 14 yıllık deneyim
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Date
2019
Authors
Güngör, Hüseyin
Bek, Kenan
Çelakıl, Mehtap Ezel
Ekinci, Zelal
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
GİRİŞ ve AMAÇ: Böbrek ve idrar yollarının konjenital anomalileri (DBÜSA) genellikle asemptomatiktir ve çeşitli toplumlarda son dönem böbrek yetmezliğinin% 30-60' ının sebebidir. ÇalışmamızdA DBÜSA'lı hastaların uzun süreli epidemiyolojik, demografik ve klinik özelliklerini paylaşmayı amaçladık. YÖNTEM ve GEREÇLER: Çalışmaya, Nisan 2002-Ocak 2016 tarihleri arasında Kocaeli Üniversitesi Tıp Fakültesi Pediatrik Nefroloji Anabilim Dalı tarafından takip edilen, 0-18 yaş arası 11725 hastadan toplam 4625 DBÜSA hastası dahil edildi. Toplamda DBÜSA olan 4625 hasta teşhis edildi. Geçici hidronefroz tespit edilen 4164 hasta çalışmadan çıkarıldı. Çalışılan 461 hastanın kayıtları retrospektif olarak değerlendirilmiş ve SPSS 20.0 programı ile analiz edilmiştir. BULGULAR: DBÜSA sıklığı% 3,9 idi. Olguların erkek / kadın oranı % 48,8 (225) /% 51,2 (236) idi. VUR % 31,5 (145) hastada tespit edildi, bunların % 71,7 (104) kadın ve% 28,3 (41) erkekti. Hidronefroz, 75 (% 162) hastada mevcuttu. Bu hastaların antenatal tanı oranı % 30,7 idi (23). UPJ obstrüksiyonu 26 (% 70,2) ve VUR 21 (% 14,4) hidronefroz ile ilişkili en sık konjenital böbrek ve üriner sistem anomalileri idi. Olguların % 50,5 (233) 'ünde idrar yolu enfeksiyonu öyküsü vardı. VUR tanısı olan hastalarda bu sıklık % 90,3 olarak saptandı. Kronik böbrek hastalığı 8 hastada mevcuttu. Bu hastaların 4'ünde (% 50) altta yatan neden VUR idi. TARTIŞMA ve SONUÇ: Son yıllarda, geçici hidronefroz prevalansı antenatal USG'nin yaygın kullanımı ile artmıştır. Bu nedenle uzun dönemde kronik böbrek hastalığı riski yüksek olan DBÜSA'lı hastalar geçici hidronefrozdan ayrılmalı ve üçüncü basamak referans merkezlerinde pediatrik nefroloji ve pediatrik üroloji ile takip edilmelidir.
INTRODUCTION: Congenital anomalies of kidney and urinary tract (CAKUT) are usually asymptomatic and the cause of 30-60 % of the end stage renal failure in various societies. We aimed to share the long-term epidemiological, demographic and clinical characteristics of the patients with CAKUT. METHODS: A total of 4625 CAKUT patients, out of 11725 patients aged 0-18 years who were followed up by Kocaeli University School of Medicine Pediatric Nephrology Department between April 2002 and January 2016 were included in the study. In total, 4625 patients with CAKUT were diagnosed and transient hydronephrosis was detected in 4164 patients. These patients were excluded from our study. The records of the patients studied were retrospectively evaluated and analyzed by SPSS 20.0 program. RESULTS: CAKUT frequency was 3.9%. The male / female ratio of the cases was 48.8% (225) / 51.2% (236). VUR was detected in 31.5% (145) patients,71.7% (104) were female and 28.3% (41) male. Hydronephrosis was present in 75 (16.2%) patients. The antenatal diagnosis rate of these patients was 30.7% (23). UPJ obstruction 26 (70.2%) and VUR 21 (14.4%) were the most common congenital renal and urinary system anomalies associated with hydronephrosis. 50.5% (233) of the cases had a history of urinary tract infection. This frequency was significantly higher in patients with VUR diagnosed as 90.3%. Chronic kidney disease was present in 8 patients. The underlying cause in 4 (50%) of these patients was VUR. DISCUSSION AND CONCLUSION: In recent years, the prevalence of transient hydronephrosis has been frequently reported with the widespread use of antenatal USG. Therefore, patients with CAKUT who have a high risk of chronic kidney disease in the long-term should be separated from transient hydronephrosis and followed up at tertiary care reference centers with pediatric nephrology and pediatric urology.
INTRODUCTION: Congenital anomalies of kidney and urinary tract (CAKUT) are usually asymptomatic and the cause of 30-60 % of the end stage renal failure in various societies. We aimed to share the long-term epidemiological, demographic and clinical characteristics of the patients with CAKUT. METHODS: A total of 4625 CAKUT patients, out of 11725 patients aged 0-18 years who were followed up by Kocaeli University School of Medicine Pediatric Nephrology Department between April 2002 and January 2016 were included in the study. In total, 4625 patients with CAKUT were diagnosed and transient hydronephrosis was detected in 4164 patients. These patients were excluded from our study. The records of the patients studied were retrospectively evaluated and analyzed by SPSS 20.0 program. RESULTS: CAKUT frequency was 3.9%. The male / female ratio of the cases was 48.8% (225) / 51.2% (236). VUR was detected in 31.5% (145) patients,71.7% (104) were female and 28.3% (41) male. Hydronephrosis was present in 75 (16.2%) patients. The antenatal diagnosis rate of these patients was 30.7% (23). UPJ obstruction 26 (70.2%) and VUR 21 (14.4%) were the most common congenital renal and urinary system anomalies associated with hydronephrosis. 50.5% (233) of the cases had a history of urinary tract infection. This frequency was significantly higher in patients with VUR diagnosed as 90.3%. Chronic kidney disease was present in 8 patients. The underlying cause in 4 (50%) of these patients was VUR. DISCUSSION AND CONCLUSION: In recent years, the prevalence of transient hydronephrosis has been frequently reported with the widespread use of antenatal USG. Therefore, patients with CAKUT who have a high risk of chronic kidney disease in the long-term should be separated from transient hydronephrosis and followed up at tertiary care reference centers with pediatric nephrology and pediatric urology.
Description
Keywords
Konjenital böbrek ve üriner sistem anomalisi, Vezikoüreteral reflü, Kronik böbrek hastalığı, Congenital kidney and urinary tract anomaly, Vesicoureteral reflux, Chronic kidney disease
Citation
Güngör, H. vd. (2019). "Konjenital böbrek ve üriner sistem anomalileri: Tek merkez 14 yıllık deneyim". Güncel Pediatri, 17(1), 45-57.