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Asian Journal of Urology 2024年第3期11卷 437-442页

作者： Yusuf Atakan Baltrak Nebil Akdogan Mutlu Deger Volkan Izol Ibrahim Atilla Aridogan Nihat Satar Division Pediatric Urology Department of UrologyMedical FacultyCukurova UniversityAdanaTurkey

Objective:vesicoureteral reflux(VUR)index is a simple,validated tool that reliably predicts significant improvement and spontaneous resolution of primary reflux in *** aim of this study was to evaluate and compare the ureter diameter ratio(UDR)and VUR index(VURx)of patients treated with endoscopic injection(EI)and ureteroneocystostomy(UNC)methods in the pediatric age group due to primary ***:Patients under the age of 18 years old who underwent EI and UNC with the diagnosis of primary VUR between January 2011 and September 2021 were determined as the *** UDR was assessed using voiding cystourethrography,and the VURx score was determined prior to treatment based on hospital records included in the ***:A total of 255 patients,60(23.5%)boys and 195(76.5%)girls,with a mean age of 76.5(range 13.0e204.0)months,were included in the *** was applied to 130(51.0%)patients and UNC was applied to 125(49.0%)patients due to primary *** optimum cut-off for the distal UDR was obtained as 0.17 with sensitivity and specificity of 73.0%and 63.0%,*** positive and negative predictive values were 66.0%and 70.0%,***:When the UDR and VURx score are evaluated together for the surgical treatment of primary VUR in the pediatric age group,it is thought that it may be useful in predicting the clinical course of the disease and evaluating surgical treatment options.

关键词： Distalureter diameter ratio vesicoureteral reflux vesicoureteral reflux index management vesicoureteral reflux index

Responsible genes in children with primary vesicoureteral reflux: findings from the Chinese Children Genetic Kidney Disease Database

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World Journal of Pediatrics 2021年第4期17卷 409-418页

作者： Jia-Lu Liu Qian Shen Ming-Yan Wu Guang-Hua Zhu Yu-Feng Li Xiao-Wen Wang Xiao-Shan Tang Yun-Li Bi Yi-Nv Gong Jing Chen Xiao-Yan Fang Yi-Hui Zhai Bing-Bing Wu Guo-Min Li Yu Bo Sun Xiao-Jie Gao Cui-Hua Liu Xiao-Yun Jiang Sheng Hao Yu-Lin Kang Ying-Liang Gong Li-Ping Rong Di Li Si Wang Duan Ma Jia Rao Hong Xu Chinese Children Genetic Kidney Disease Database(CCGKDD) “Internet Plus”Nephrology Alliance of the National Center for Children’s Care Department of Nephrology Children’s Hospital of Fudan UniversityNational Children’s Medical Center399 Wan Yuan RoadShanghai201102People’s Republic of China Shanghai Kidney Development and Pediatric Kidney Disease Research Center ShanghaiChina Department of Nephrology Shanghai Children’s HospitalShanghaiChina Department of Pediatric Nephrology Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina Wuhan Children’s Hospital Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina Department of Urology Children’s Hospital of Fudan UniversityNational Children’s Medical CenterShanghaiChina Department of Rheumatology Children’s Hospital of Fudan UniversityNational Children’s Medical CenterShanghaiChina Clinical Genetic Center Children’s Hospital of Fudan UniversityNational Children’s Medical CenterShanghaiChina Department of Nephrology Shenzhen Children’s HospitalShenzhenGuangdongChina Department of Nephrology and Rheumatology Children’s Hospital Affiliated to Zhengzhou UniversityZhengzhou Key Laboratory of Pediatric Kidney Disease ResearchZhengzhouChina The First Affiliated Hospital of Zhongshan University GuangzhouChina Key Laboratory of Metabolism and Molecular Medicine Ministry of EducationDepartment of Biochemistry and Molecular BiologyInstitutes of Biomedical SciencesSchool of Basic Medical SciencesFudan UniversityShanghaiChina 不详

Background Primary vesicoureteral reflux(VUR)is a common congenital anomaly of the kidney and urinary tract(CAKUT)in *** present study identified the possible genetic contributions to primary VUR in *** Patients with primary VUR were enrolled and analysed based on a national multi-center registration network(Chinese Children Genetic Kidney Disease Database,CCGKDD)that covered 23 different provinces/regions in China from 2014 to *** causes were sought using whole-exome sequencing(WES)or targeted-exome *** A total of 379 unrelated patients(male:female 219:160)with primary VUR were ***-four(16.9%)children had extrarenal manifestations,and 165(43.5%)patients showed the coexistence of other CAKUT ***-eight patient(23.2%)exhibited impaired renal function at their last visit,and 18 of them(20.5%)developed ESRD at the median age of 7.0(IQR 0.9–11.4)years.A monogenic cause was identified in 28 patients(7.39%).These genes included PAX2(n=4),TNXB(n=3),GATA3(n=3),SLIT2(n=3),ROBO2(n=2),TBX18(n=2),and the other 11 genes(one gene for each patient).There was a significant difference in the rate of gene mutations between patients with or without extrarenal complications(14.1%vs.6%,P=0.035).The frequency of genetic abnormality was not statistically significant based on the coexistence of another CAKUT(9.6%vs.5.6%,P=0.139,Chi-square test)and the grade of reflux(9.4%vs.6.7%,P=0.429).Kaplan–Meier survival curve showed that the presence of genetic mutations did affect renal survival(Log-rank test,P=0.01).PAX2 mutation carriers(HR 5.1,95%CI 1.3–20.0;P=0.02)and TNXB mutation carriers(HR 20.3,95%CI 2.4–168.7;P=0.01)were associated with increased risk of progression to *** PAX2,TNXB,GATA3 and SLIT2 were the main underlying monogenic causes and accounted for up to 46.4%of monogenic *** complications and renal function were significantly related to the findings of genetic factors in children with p

关键词： Children Congenital anomalies of the kidney and urinary tract Gene mutation vesicoureteral reflux Whole-exome sequencing

Relationship between vesicoureteral reflux and Glomerular Filtration Rate in Children

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Current Medical Science 2020年第5期40卷 845-850页

作者： Wei ZHANG Hui-ming YI Xiao-le ZHANG Yong-hong YI Jian-hua ZHOU Li-ru QIU Department of Ultrasound Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Pediatrics Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

vesicoureteral reflux(VUR)is one of the most common urinary tract anomalies in children and causes renal damage and studies focusing on the effect of VUR on renal function are *** recruited 35 primary VUR patients with recurrent urinary tract infection(UTI)and 10 non-VUR patients with recurrent ***-enhanced voiding urosonography(ceVUS)was performed for VUR grading,and renal dynamic imaging was used for evaluating glomerular filtration rate(GFR,mL/min).Standardized GFR(sGFR),namely GFR/BSA(mL·min-1·m-2),was calculated based on the body surface area(BSA).Total sGFR(tsGFR,mL·min-1·m-2)was obtained from the sum of sGFR on the left and right sides of all the *** risk of renal regurgitation was equal in the unilateral reflux *** sGFR of children with grade Ⅳ(45.74±18.05mL·min-1·m-2)and grade V(49.67±23.63mL·min-1·m-2)reflux was significantly lower than that in children with grade Ⅱ(77.69±22.21 mL·min-1·m-2).The renal function compensation of contralateral non-reflux kidney increased in unilateral reflux group,which was higher than that in the control group and level Ⅱ,Ⅳ and Ⅴ of reflux group *** VUR group of the same grade,sGFR decreased with the age at *** unilateral grade V refux group,the tsGFR was lower than that in the unilateral grade I reflux group(133.51±48.21 vs.186.87+53.49mL·min-1·m-2).The patients with VUR of unilateral grade Ⅱ were significantly older than those with VUR of unilateral grades Ⅱ and Ⅳ.This study indicates that severe VUR is significantly associated with decreased renal ***,VUR should be diagnosed early and managed individually.

关键词： vesicoureteral reflux renal dynamic imaging glomerular filtration rate renal damage children

Long term outcomes of Cohen’s cross trigonal reimplantation for primary vesicoureteral reflux in poorly functioning kidney

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World Journal of Clinical Cases 2023年第16期11卷 3750-3755页

作者： Mohd Sualeh Ansari Ravi Banthia Shrey Jain Vinay N Kaushik Nayab Danish Priyank Yadav Department of Urology and Renal Transplantation Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknow 226014Uttar PradeshIndia

BACKGROUND Open ureteric reimplantation by cross trigonal technique described by Cohen is considered a common surgical option for correction of vesicoureteral reflux(VUR). There is a lack of evidence in literature though for what happens to such kidneys, in the long run, particularly those which are poorly *** To assess the long-term outcomes of ureteric reimplantation in poorly functioning kidneys in children with unilateral primary *** Children with unilateral primary VUR and a relative renal function of less than 35% who underwent open or laparoscopic ureteric reimplantation between January 2005 and January 2017 were included in the study. Patients who had a follow up of less than five years were excluded. Preoperative evaluation consisted of a voiding cystourethrogram and Dimercaptosuccinic acid(DMSA) scan. In the follow-up period, patients underwent a diuretic scan at 6 weeks and 6 *** up ultrasound was done for change in grade of hydronephrosis and retrovesical ureteric diameter. Subsequent follow up was done at 6 monthly intervals with evaluation for proteinuria and hypertension and any recurrent urinary tract infection(UTI). For assessment of cortical function, DMSA was repeated annually for 5 years after surgery. A paired-samples t-test was used to test the mean difference of DMSA between pre-post *** During this period, 36 children underwent ureteric reimplantation for unilateral primary VUR. After excluding those with insufficient follow-up, 31 were included in the analysis. Most of the patients were males(n = 26/31, 83.8%). Patient’s age(mean ± SD, range) was 5.21 ± 3.71, 1-18 years. The grades of VUR were grade Ⅱ(1patient), grade Ⅲ(8 patients), grade Ⅳ(10 patients), and grade Ⅴ(12 patients). The pre and postoperative DMSA was 24.064 ± 12.02 and 24.06 ± 10.93, which was almost the same(statistically equal, paired-samples t-test: P = 0.873). The median(range) follow-up duration was 82(60-120)mo. One patient h

关键词： vesicoureteral reflux Ureteric reimplantation Relative renal function Poorly functioning kidney Unilateral Long term

Modified unilateral periureteral injection technique in the treatment of patients with high-grade vesicoureteral reflux: A study of primary findings

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Asian Journal of Urology 2023年第1期10卷 96-100页

作者： Seyed Alaeddin Asgari Afshin Safaei-Asl Mandana Mansour-Ghanaie Seyed Mohammad Asgari Asghar Faryabi Mohammadreza Bazli Faezeh Emami Sigaroudi Seyed Ahmad Naseri Alavi Urology Research Center Razi HospitalSchool of MedicineGuilan University of Medical SciencesRashtIran School of Medicine Guilan University of Medical SciencesRashtIran Faculty of Medicine Tabriz University of Medical SciencesTabrizIran

Objective:Although endoscopic treatment has been used by many pediatric urologists for the treatment of vesicoureteral reflux(VUR),it has no considerable success in high-grade *** aimed to describe the primary outcomes of unilateral periureteral injection technique(PIT),as well as bilateral PIT in high-grade ***:In this prospective study,we examined 92 ureters in 45 boys and 40 girls from February 2010 to May *** PIT and unilateral PIT were applied in 67 and 25 refluxing units,*** the unilateral PIT,the subureteral injection site was only at the 5-or 7-o’clock ***,in the bilateral PIT,the subureteral injection sites were at 5-and 7-o’clock ***-and post-operative reflux grades were evaluated by voiding cystourethrography 6 months after ***:Seven patients had bilateral ***,75(81.5%)ureters showed Grade IV VUR,while 17(18.5%)had primary Grade V *** mean age of the subjects was 39.2 *** unilateral PIT ureters,VUR was resolved in 23(92.0%)refluxing *** was downgraded to Grade III in one ureter(4.0%)and to Grade II in another ureter(4.0%).In addition,in bilateral PIT cases,VUR was resolved in 60(89.6%)ureters;it downgraded to Grades II and III in 3(4.5%)and 4(6.0%)refluxing units,***:Unilateral PIT can be highly effective in the treatment of selected ureters of high-grade ***,further studies are needed to confirm our results.

关键词： Periureteral injection technique Bilateral periureteral injection technique Unilateral periureteral injection technique Endoscopy vesicoureteral reflux

Hereditary vesicoureteral reflux: A Study of 66 Families

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Open Journal of Pediatrics 2015年第4期5卷 304-313页

作者： Zsuzsa IBartik Agneta Nordenskjold Sofia Sjostrom Rune Sixt Ulla Sillen The Pediatric Uro-Nephrologic Centre The Queen Silvia Children’s HospitalSahlgrenska AcademyUniversity of GothenburgGothenburgSweden Department of Women and Children Health Karolinska Institutet and Center of Molecular MedicineKarolinska University HospitalStockholmSweden

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.

关键词： vesicoureteral reflux Heredity Phenotype

Off-label-use of sulfur-hexafluoride in voiding urosonography for diagnosis of vesicoureteral reflux in children:A survey on adverse events

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World Journal of Clinical Pediatrics 2017年第1期6卷 52-59页

作者： Alexander Sauer Clemens Wirth Isabel Platzer Henning Neubauer Simon Veldhoen Alexander Dierks Reinhard Kaiser Andreas Kunz Meinrad Beer Thorsten Bley Section of Pediatric Radiology Department of Diagnostic and Interventional RadiologyUniversity Hospital Wuerzburg Department of Diagnostic and Interventional Radiology University Hospital Wuerzburg Department of Pediatrics Hegau-Bodensee-Hospital Singen Department of Diagnostic and Interventional Radiology University Hospital Ulm

AIM To evaluate the risk profile of sulfur hexafluoride in voiding urosonography(VUS) based on a large cohort of *** Since 2011 sulfur hexafluoride(SH,SonoV ue?,Bracco,Italy) is the only ultrasound contrast available in the European Union and its use in children has not been *** a 4-year-period,531 children with suspected or proven vesicoureteral reflux(f/m = 478/53; mean age 4.9 years; 1 mo-25.2 years) following parental informed consent underwent VUS with administration of 2.6 ± 1.2 mL SH in a two-center study.A standardizedtelephone survey on adverse events was conducted three days *** No acute adverse reactions were *** survey revealed subacute,mostly self-limited adverse events in 4.1%(22/531).The majority of observed adverse events(17/22) was not suspected to be caused by an allergic reaction: Five were related to catheter placement,three to reactivated urinary tract infections,five were associated with perineal disinfection before voiding urosonography or perineal dermatitis and four with a common *** five patients(0.9%) hints to a potential allergic cause were noted: Perineal urticaria was reported in three interviews and isolated,mild fever in *** were minor self-limited adverse events with a subacute onset and no hospital admittance was ***-six point two percent of the parents would prefer future VUS examinations with use of *** No severe adverse events were observed and indications of self-limited minor allergic reactions related to intravesical administration of SH were reported in less than 1%.

关键词： Voiding urosonography Ultrasound contrast agent vesicoureteral reflux SonoV ue Adverse events Sulfur hexafluoride

Comparative study of conventional urosonography without contrast enhancement and x-ray voiding cystourethrography for diagnosis of vesicoureteral reflux in children

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Discussion of Clinical Cases 2020年第4期7卷 9-14页

作者： Nadide Basak Gulleroglu Kaan Gulleroglu Esra Baskin Ankara City Hospital Children’s Hospital Pediatric RadiologyAnkaraTurkey Baskent University Pediatric NephrologyAnkaraTurkey

Background:vesicoureteral reflux is the most common urinary congenital anomaly in *** the risk associated with radiation exposure there has been an increasing need for radiation-free method in the diagnosis and follow-up of the vesicoureteral *** aim of our study is to compare conventional urosonography without contrast enhancement and x-ray voiding *** and Methods:Children with recurrent urinary tract infection with suspected vesicoureteral reflux were included to the *** reflux is demonstrated and graded by x-ray voiding *** is used for the evaluation of renal *** sonographic procedure was performed in all *** junction insertion angle was *** diameter and length of the ureterovesical junction were also ***:268 children enrolled to the *** reflux was demonstrated in 62 children by x-ray voiding *** junction insertion angle measurement had a statistically significant relation for right and left vesicoureteral reflux presence(right:r:.646,p:.01 and left:r:.446,p:.01).Diagnosis sensitivity of vesicoureteral reflux with conventional ultrasonography is 95.10%and specificity is 81%(Youden’s index 76.1%)for the cutoff value of the ureterovesical junction insertion angle is 28.6 *** predictive value is 87.2%,negative predictive value is 94.73%and diagnostic accuracy is 86.29%with conventional ***:Measurement of ureterovesical junction insertion angle,length and diameter by conventional urosonography is an easy accessible and cheap technique with high sensitivity and specificity for the diagnosis and followup of the vesicoureteral reflux without exposure to ionizing radiation.

关键词： vesicoureteral reflux Conventional urosonography X-ray voiding cystourethrography Ureterovesical junction insertion angle

Diagnosis and management of ureteral complications following renal transplantation

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Asian Journal of Urology 2015年第4期2卷 202-207页

作者： Brian D.Duty John M.Barry Department of Urology Oregon Health&Science UniversityPortlandORUSA Department of Surgery Division of Abdominal Organ TransplantationOregon Health&Science UniversityPortlandORUSA

When compared with maintenance dialysis,renal transplantation affords patients with end-stage renal disease better long-term survival and a better quality of *** 9% of patients will develop a major urologic complication following kidney *** complications are most common and include obstruction(intrinsic and extrinsic),urine leak and vesicoureteral *** anastomotic strictures result from technical error or ureteral *** dilation or endoureterotomy may be considered for short,low-grade strictures,but open reconstruction is associated with higher success *** leak usually occurs in the early postoperative *** 60% of patients can be successfully managed with a pelvic drain and urinary decompression(nephrostomy tube,ureteral stent,and indwelling bladder catheter).Proximal,large-volume,or leaks that persist despite urinary diversion,require open *** reflux is common following *** with recurrent pyelonephritis despite antimicrobial prophylaxis require surgical *** injection may be considered in recipients with low-grade *** IV and V reflux are best managed with open reconstruction.

关键词： Renal transplantation Ureteral stricture Ureteral obstruction Urine leak vesicoureteral reflux

Treatment of mid and distal ureteric calculi in preschool children with ureteroscopy

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Treatment of mid and distal ureteric calculi in preschool ch...