PMID- 17620693
OWN - NLM
STAT- MEDLINE
DCOM- 20071016
LR  - 20131121
IS  - 0019-6061 (Print)
IS  - 0019-6061 (Linking)
VI  - 44
IP  - 6
DP  - 2007 Jun
TI  - Risk factors for renal injury in patients with meningomyelocele.
PG  - 417-20
AB  - PATIENTS AND METHODS: Thirty operated patients of myelodysplasia were clinically 
      evaluated for the age at presentation, the extent of lesion and neurological 
      deficit. Urological assessment was done with urine cultures, serum creatinine, 
      radiological (ultrasound of kidney, ureters and bladder, voiding 
      cystourethrogram) and urodynamic (water cystometry) parameters. An objective 
      scoring for bladder (Galloway, et al.) was applied. Dimercapto-succinic acid 
      (DMSA) scan was done in all the patients for evidence of renal scars. The results 
      of above investigations were correlated with presence or absence of renal scars 
      (renal injury) on DMSA scan. None of the patients had received any prior bladder 
      care. RESULTS: Twenty one patients had no renal scars and 9 patients had evidence 
      of renal scarring. Patients with renal scars were older at presentation, they had 
      greater degree of hydroureteronephrosis (P < or = 0.001) and vesicoureteric 
      reflux (P < or = 0.005). The incidence of high leak pressures (>25 cm of water, P 
      < or = 0.05), unacceptable bladder volumes (maximum cystometric capacity < 60% 
      for age, P < or = 0.005) and high risk Galloway's score (> 5, P < or = 0.05) was 
      high in patients with associated renal scarring as compared to their nonscarred 
      counterparts. Three of these patients had serum creatinine >1 mg/dl (P < or = 
      0.005). The incidence of urinary complaints and positive urine cultures was also 
      higher in these patients (NS). CONCLUSION: Increasing age, evidence of 
      hydroureteronephrosis and vesicoureteric reflux, high leak pressures, low bladder 
      volume and high combined Galloway score (>5) define a high risk bladder in our 
      population and predispose to renal injury in patients of myelodysplasia. Early 
      referral for bladder risk assessment and management of all myelodysplasia 
      patients is recommended.
FAU - Arora, Garima
AU  - Arora G
AD  - Department of Pediatric Surgery, Post Graduate Institute of Medical Education and 
      Research, Chandigarh, India.
FAU - Narasimhan, K L
AU  - Narasimhan KL
FAU - Saxena, A K
AU  - Saxena AK
FAU - Kaur, Balpinder
AU  - Kaur B
FAU - Mittal, B R
AU  - Mittal BR
LA  - eng
PT  - Journal Article
PL  - India
TA  - Indian Pediatr
JT  - Indian pediatrics
JID - 2985062R
RN  - DX1U2629QE (Succimer)
SB  - IM
MH  - Age Factors
MH  - Female
MH  - Humans
MH  - Incidence
MH  - India/epidemiology
MH  - Kidney Diseases/epidemiology/*etiology
MH  - Male
MH  - Meningomyelocele/*complications
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Succimer
EDAT- 2007/07/11 09:00
MHDA- 2007/10/17 09:00
CRDT- 2007/07/11 09:00
PHST- 2007/07/11 09:00 [pubmed]
PHST- 2007/10/17 09:00 [medline]
PHST- 2007/07/11 09:00 [entrez]
PST - ppublish
SO  - Indian Pediatr. 2007 Jun;44(6):417-20.