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Risk factors for renal outcomes in children with antineutrophil cytoplasmic antibody-associated vasculitis:a nationwide retrospective study in China

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World Journal of Pediatrics 2024年第5期20卷 506-516页

作者： Li-Wen Tan Jun-Li Wan Chun-Hua Zhu Hong Xu Zheng-Kun Xia Li-Zhi Chen Xiao-Chuan Wu Fang Wang Xiao-Rong Liu Cheng-Guang Zhao Xiao-Zhong Li Jian-Hua Mao Xiao-Wen Wang Wen-Yan Huang Yu-Hong Li Jian-Jiang Zhang Shi-Pin Feng Jun Yang Jiao-Jiao Liu Chun-Lin Gao Li-Ping Rong Lan-Jun Shuai Ke Xu He-Jia Zhang Qiu Li Ai-Hua Zhang Mo Wang Department of nephrology Children’s Hospital of Chongqing Medical UniversityZhongshan 2nd Rd.136Chongqing400014China Ministry of Education Key Laboratory of Child Development and Disorders National Clinical Research Center for Child Health and DisordersChina International Science and Technology Cooperation Base of Child Development and Critical DisordersChildren’s Hospital of Chongqing Medical UniversityChongqingChina Chongqing Key Laboratory of Pediatrics Children’s Hospital of Chongqing Medical UniversityChongqingChina Department of nephrology Children’s Hospital of Nanjing Medical University72 Guangzhou RoadNanjing210008China Department of nephrology Children’s Hospital of Fudan UniversityNational Paediatric Medical Center of ChinaShanghaiChina Department of Pediatrics Jinling HospitalNanjing Medical UniversityNanjingChina Department of Pediatrics Jinling HospitalThe First School of Clinical MedicineSouthern Medical UniversityNanjingChina Department of Pediatrics Jinling HospitalMedical School of Nanjing UniversityNanjingChina Department of Pediatric nephrology and Rheumatology The First Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouChina Department of Pediatrics The Second Xiangya Hospital of Central South UniversityChangshaChina Department of Pediatrics Peking University First HospitalBeijingChina Department of nephrology Beijing Children’s HospitalCapital Medical UniversityBeijing100045China National Center for Children’s Health BeijingChina Department of Pediatrics Shengjing Hospital of China Medical UniversityShenyangChina Department of nephrology and Immunology Children’s Hospital of Soochow UniversitySuzhouChina Department of nephrology Children HospitalZhejiang University School of MedicineHangzhouChina Department of nephrology Wuhan Children’s Hospital(Wuhan Maternal and Child Healthcare Hospital)Tongji Medical CollegeHuazhong University of Science&TechnologyWuhanChina Department of nephrology and Rheumatology Shanghai Children’s HospitalSchool

Background Pediatric antineutrophil cytoplasmic antibody-associated vasculitis(AAV)is a life-threatening systemic vasculitis featured by liability to renal ***,there are few studies on the risk factors and predictive models for renal outcomes of AAV in *** Data from 179 AAV children in multiple centers between January 2012 and March 2020 were collected *** risk factors and predictive model of end-stage renal disease(ESRD)in AAV were *** Renal involvement was the most typical manifestation(95.5%),and the crescent was the predominant pathological lesion(84.9%).The estimated glomerular filtration rate(eGFR)was evaluated in 114 patients,of whom 59.6%developed ESRD,and the median time to ESRD was 3.20 *** eGFR[P=0.006,odds ratio(OR)=0.955,95%confidence interval(CI)=0.924–0.987]and the percentages of global glomerulosclerosis(pGGS;P=0.018,OR=1.060,95%CI=1.010–1.112)were independent risk factors for ESRD of renal *** on the pGGS and eGFR at renal biopsy,we developed three risk grades of ESRD and one predictive *** Kaplan‒Meier curve indicated that renal outcomes were significantly different in different risk grades(P<0.001).Compared with serum creatinine at baseline,the predictive model had higher accuracy(0.86 versus 0.58,P<0.001)and a lower coefficient of variation(0.07 versus 0.92)in external *** Renal involvement is the most common manifestation of pediatric AAV in China,of which more than half deteriorates into *** predictive model based on eGFR at renal biopsy and the pGGS may be stable and accurate in speculating the risk of ESRD in AAV children.

关键词： Antineutrophil cytoplasmic antibody End-stage renal disease Glomerulonephritis Pediatric nephrology Vasculitis

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Neonatal Intestinal Obstruction in Acute Renal Failure in Premature Infant: A Case Report

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Open Journal of Pediatrics 2024年第2期14卷 338-343页

作者： Ondima Lucienne Irène Patricia Okiemy Niendet Cardinale Princilia Gandzali-Ngabe Pierre Eric Caryne Mboutol-Mandavo Bosseba Missengui Rhodia Hélène Akobande Nuptia Erica Department of paediatric Surgery CHU Brazzaville Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Department of nephrology and Dialysis Brazzaville University Hospital Brazzaville Congo

Introduction: Intestinal obstruction is a common cause of abdominal surgery in the neonate. Diagnosis is straightforward using standard radiology, and surgical technique depends on the underlying anatomical lesion. Peritoneal dialysis (PD) is an effective, albeit invasive, therapy for neonatal renal failure. We report a case of neonatal obstruction with severe renal failure treated by PD to highlight our hospital practice and possible remedies in a context of limited resources. Case Presentation: This was a female neonate of moderate prematurity admitted on day 4 of life for management of a flat neonatal obstruction. Radiological diagnosis suggested small bowel atresia. Biological tests revealed severe renal failure with creatinine levels of 416 micromoles per liter and blood urea of 27.1 micromoles per liter. Management consisted of preoperative peritoneal dialysis for 48 hours followed by laparotomy. The intraoperative diagnosis was GROSFELD type IIIa digestive atresia. The postoperative course was favourable, transit was resumed on day 5 and the patient returned home on day 12. Progress at 3 months was satisfactory. Conclusion: Neonatal intestinal obstruction with renal failure in premature infants is associated with a poor prognosis, even more so if there is a delay in treatment. Peritoneal dialysis seems to be a suitable alternative for this management in our working conditions with limited resources.

关键词： Neonate Occlusion Peritoneal Dialysis Case Report

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Functional constipation in Bangladeshi school aged children:A hidden misty at community

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World Journal of Clinical Pediatrics 2022年第2期11卷 160-172页

作者： Md Benzamin ASM Bazlul Karim Md Rukunuzzaman Md Wahiduzzaman Mazumder Masud Rana Rubaiyat Alam Mohammad Majharul Islam Md Shafiul Alam Kamal Hossen Afsana Yasmin Kaniz Fathema Mukesh Khadga Aisharza Sultana Aishy Department of paediatric Gastroenterology and Nutrition Bangabandhu Shiekh Mujib Medical UniversityDhaka 1000Bangladesh Department of Outpatient Hazi Asmot Medical CentreBhairab 2350Bangladesh Department of paediatric nephrology Bangabandhu Shiekh Mujib Medical UniversityDhaka 1000Bangladesh Jalalabad Ragib Rabeya Medical College Sylhet 3100Bangladesh

BACKGROUND Constipation is a common problem in children and a frequent cause of hospital visit in both primary&specialized care,which needs proper evaluation&*** of constipation is variable among *** Bangladesh there has been no published data regarding constipation in community among school aged *** To determine the magnitude of functional constipation and its risk factors in community among Bangladeshi school *** This descriptive cross sectional study was conducted in different schools of Dhaka division,*** school aged children between 5-16 years of age who attended school were included in this *** were collected *** clinical history&physical examinations(without digital rectal examination)&available investigations(if done previously)were *** of functional constipation was done by Rome IV criteria and was compared with children without *** with any red flag sign,known chronic disease or any findings suggestive of organic disease and on treatment of constipation were *** analysis of the results was done by using Windows based software device with Statistical Packages for Social Science *** all statistical tests,P value of less than 0.05 was considered as statistically *** Total study populations were 707 and male was 443 and female *** them,134(19%)children had *** constipated children,78 children fulfilled the Rome IV criteria for functional constipation and it was 11%of total *** age of children having functional constipation was 11.24±3.54 years and Male female ratio was 1:***,nausea,abdominal pain,hard stool,blood with hard stool,alternate hard and loose stool and fecal mass in left iliac fossa were analyzed between two group and all were significantly higher in children with functional constipation *** of school,where toilet numbers were inadequate had 2.5 time

关键词： Bangladesh Children Functional constipation

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Determining the Bulk of the Iceberg of Proteinuric Chronic Kidney Disease in School Children, in South West Nigeria

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Open Journal of Pediatrics 2023年第3期13卷 291-303页

作者： Adebukola Ajite Wasiu Olowu Department of paediatric Ekiti State University Teaching Hospital Ado Ekiti Nigeria paediatric nephrology and Hypertension Unit Department of Paediatrics OAUTHC Ile Ife Nigeria

Introduction: Chronic kidney disease [CKD], as defined by the National Kidney Foundation/Kidney Disease and Outcome Quality Initiative (KDOQI) Group, refers to bilateral kidney injury and/or impaired kidney function of at least 3 months duration. Persistent proteinuria has been recognized as one of the early markers of chronic kidney disease and has been associated with persistent and progressive damage in both children and adult. This study was conducted with the aim of determining the prevalence and severity of persistent proteinuria over three months in primary school children in Ile-Ife. It was a cross-sectional study done over a period of six months. The subjects were 1335 primary school pupils, aged 6 to 14 years selected by multi stage random sampling method from twelve primary schools from a total of 96,301 pupils in the two Local Government Areas (LGA) of Ile-Ife, after meeting the recruitment criteria. The biodata, physical examination, blood pressure measurements and urine testing by dipstick were carried out on all the recruited pupils according to standard protocols while serial monitoring of proteinuria and estimated glomerular filtration rate was done for those with persistent proteinuria over 6 months. Results: Initially 34 (2.6%) of the subjects recruited had significant proteinuria with a M:F ratio of 1:1.6 following first screening and it was persistent in six (0.4%) of them subsequently over three months with a M:F ratio of 1:1.5. The severity of the persistent proteinuria was in the range of 30 mg/dL to 100 mg/dL. Three of them (50%) had worsened level of proteinuria from 30 mg/dL to 100 mg/dl on follow up. Conclusion: Children with undetected persistent proteinuria stand the risk of further glomerular damage over time.

关键词： Persistent Proteinuria Chronic Kidney Disease Glomerular Damage

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Tubulointerstitial nephritis and uveitis syndrome post-COVID-19

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Pediatric Investigation 2023年第1期7卷 57-59页

作者： Maria Cristina Maggio Filippo Collura Maria Michela D’Alessandro Barbara Gramaglia Giovanni Corsello University Department PROMISE"G.D’Alessandro University of Palermo-Children Hospital"G.Di Cristina"A.R.N.A.S.PalermoItaly U.O.C.of paediatric nephrology Children Hospital"G.Di Cristina"A.R.N.A.S.PalermoItaly

To the editor:The angiotensin-converting-enzyme-2(ACE2)receptor is expressed in many extrapulmonary organs:eyes(conjunctival,corneal,and limbal epithelial cell,retina),nerves,vessels,small intestine enterocytes,kidney... 详细信息

关键词： ACE2 intestine organs

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Evaluation of Glomerular Hyperfiltration and Albuminuria in Sickle Cell Disease Adolescents: Cross-Sectional Retrospective Study

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Open Journal of nephrology 2021年第3期11卷 321-334页

作者： Nosakhare Joyce Iduoriyekemwen Caroline Booth Marilyn McDougall Psalm Duniya Baba Inusa Advance paediatric Masters Programme King’s College London London UK paediatric nephrology Unit Department of Child Health University of Benin Teaching Hospital Benin City Nigeria Department of paediatric nephrology Evelina Children Hospital London UK Department of paediatric Critical Care Evelina Children Hospital London UK Department of paediatric Haematology Evelina Children Hospital London UK

Background: Sickle Cell Disease (SCD) renal abnormalities commence early in childhood. The glomerular abnormalities, glomerular hyperfiltration and albuminuria are the most prevalent. However, these SCD glomerulopathies have not been considered exclusively in the adolescent age group. Objective: To determine the prevalence of glomerular hyperfiltration and albuminuria as well as identify the determinants for glomerular hyperfiltration in adolescents with SCD. Patients and Methods: The electronic patient records of 153 adolescents with SCD aged 10 - paediatrics Haematology Clinic at Evelina London Children’s Hospital, United Kingdom, were reviewed from the 10th to 23rd June 2019. Clinical information and laboratory parameters were obtained. The glomerular filtration rate was derived using the Bedside Schwartz’s method. Grouping of the adolescents was based on the presence and absence of glomerular hyperfiltration, which was defined as glomerular filtration rate > 140 ml/min/m2. The presence of albuminuria was defined as urine albumin-to-creatinine ratio > 3 mg/mmol or protein-to-creatinine ratio of >15 mg/mmol. The clinical and laboratory determinants of glomerular hyperfiltration in the total study population were investigated. Result: Prevalence of glomerular hyperfiltration was 33.3% in the adolescents studied, and that of albuminuria was 15.7% amongst the SCD adolescents studied, of which 13.7% of those with glomerular hyperfiltration also had albuminuria. On univariable analysis, the SCD adolescents with glomerular hyperfiltration had significantly lower weight (48.0 ± 18.0 versus 54.8 ± 17.0 kg;p = 0.02), height (155.1 ± 13.1 versus 160.6 ± 13.1 cm;p = 0.01), body mass index (19.4 ± 5.0 versus 21.0 ± 4.3;p = 0.04), haemoglobin level (88.7 ± 13.3 versus 98.1 ± 21.7 g/L;p = 0.001), and serum creatinine level (0.4 ± 0.1 versus 0.6 ± 0.2 mg/dl;p = 0.0001) as compared to tho

关键词： Glomerular Hyperfiltration Albuminuria Sickle Cell Disease Adolescent

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Attenuation of glomerular filtration barrier damage in adriamycin-induced nephropathic rats with bufalin: An antiproteinuric agent

Attenuation of glomerular filtration barrier damage in adria...

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2012年江浙沪儿科学术年会暨浙江省医学会儿科学分会学术年会、儿内科疾病诊治新进展国家级学习班

作者： Jun Zheng Jing Gong Aiqing Zhang Shanwen Li Zhifeng Zeng Ying Han Weihua Gan Department of paediatric nephrology The Second Affiliated Hospital of Nanjing Medical University

Proteinuria is an important risk factor for the progression and prognosis of chronic kidney disease. Bufalin, a cardiotonic steroid, has been shown to posses a variety of biological activities including cardiotonic, anaesthetic and antineoplastic activities, and regulate the immune response. This study investigated the effects of bufalin against proteinuria and glomerular filtration barrier damage in rats with adriamycin (ADR)-induced nephropathy. We compared the blood and urine biochemical indices and the histologic and ultrastructure of the glomerulus in ADR rats with and without the intervention of bufalin or prednisone. The transcription, expression and distribution of the podocyte-associated molecules were compared utilising RT-PCR, western blotting and immunohistochemical staining. We found that bufalin reduced the urinary protein excretion and optimised the lipidaemia of the ADR rats. Bufalin alleviated the removal of podocyte foot processes and attenuated the changes in nephrin, podocin and integrinlinked kinase (ILK) stainings in the glomerulus of the ADR rats. Bufalin notably decreased the expression of nephrin and ILK but inhibited the down-regulation of podocin in protein levels on the renal cortex of the ADR rats. Additionally, bufalin inhibited the up-regulation of podocin and ILK in mRNA levels but did not affect nephrin mRNA levels. These results suggest that bufalin could alleviate ADR-induced proteinuria by protecting the glomerular filtration barrier and may be a novel potential therapeutic agent for proteinuria-associated kidney disease.

关键词： An antiproteinuric agent Attenuation of glomerular filtration barrier damage in adriamycin-induced nephropathic rats with bufalin

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Applying the WHO instead of CDC growth charts may double obesity rates

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Open Journal of Pediatrics 2013年第2期3卷 139-146页

作者： Abeer Yasin Guido Filler Department of paediatrics Division of Paediatric Nephrology Children’s Hospital London Health Sciences Centre London Canada

Aims: This study compares the WHO (2007) and the National Health Examination Survey (NHANES III) reference intervals and investigates the differences when applied on a Canadian cohort of older children and adolescents. Methods: We calculated height, weight and BMI z-scores of 4375 consecutive patients (1993 female, 45.6%) aged 5 - 20 years attending outpatient clinics at a single tertiary care centre using reference data of the latest NHANES (III) survey and the WHO (2007) growth charts. To address age dependency, data was stratified into age groups. Results: Using the NHANES III reference intervals, medians of weight (+0.46), height (+0.29) and BMI z-scores (+0.46) were significantly non-zero. The WHO (2007) growth charts yielded medians of +2.05, +0.32, +0.53 for weight, height and BMI z-scores respectively, all significantly non-zero. When comparing both growth charts, Canadian children had significantly different weight and BMI z-scores (p 95th percentile) doubled from 8.6% to 16.0%. A significant age dependency was observed with higher WHO (2007) weight z-scores (>7 years) and higher BMI z-scores (7 to 13 years) and no significant difference was observed for height z-scores across all age groups. Gender differences were observed for weight z-scores (>9 years) and BMI (males: 9 - 11 years, p = 0.0118;11 - 13 years, p = 0.0069) whereas no significant difference was found in height z-scores across all age groups. Conclusion: Our results reveal substantial differences between both reference populations and thus interpretation needs be done with caution, especially when labelling results as abnormal.

关键词： WHO NHANES Height z-Score Weight z-Score BMI z-Score Bland & Altman Agreement Obesity Rates

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Antibiotics Prophylaxis in Patients with CAKUT, Does It Actually Prevent UTI? A Single Center Experience at South Africa

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Open Journal of nephrology 2018年第4期8卷 94-104页

作者： Nneka Chioma Okoronkwo Abdullahi Mudi Cecil Levy Thuli Khumalo G. Moonsamy Department of paediatrics Abia State University Uturu Nigeria Department of paediatrics Bayero University Kano State Nigeria Division of paediatric nephrology Charlotte Maxeke Johannesburg Academic Hospital South Africa

Background: Congenital anomalies of the kidney and urinary tract (CAKUT) are a well-documented risk factor for the development of urinary tract infection (UTI) in children. Prevention of UTI in this group of patients is advocated due to their increased risk of renal scarring, hypertension and end stage kidney failure. Methods: A 10-year retrospective review of CAKUT patients at the Johannesburg Academic Hospital, who were placed on prophylactic antibiotics over a certain period was done. The rate of UTI, the types of causative organisms isolated and the efficacy of prophylactic antibiotics in preventing UTI were documented. Results: Thirty-six (36) out of 134 patients had been started on prophylactic antibiotics after the diagnosis of CAKUT was made. There was a statistically significant association between the use of prophylactic antibiotics and the rate of UTI (p Conclusion: Antibiotic prophylaxis was very effective in decreasing the rate of UTI in our cohort of patients with CAKUT.

关键词： Antibiotic Prophylaxis Children CAKUT UTI South Africa

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Efficacy and safety of Huaiqihuang granule as adjuvant treatment for primary nephrotic syndrome in children: a meta-analysis and systematic review

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World Journal of Pediatrics 2021年第3期17卷 242-252页

作者： Jiao Lin Li-Min Huang Jing-Jing Wang Jian-Hua Mao Department of nephrology National Clinical Research Center For Child HealthChildren’s HospitalZhejiang University School of MedicineHangzhou 310003China

Background Huaiqihuang(HQH)granule is a traditional Chinese herbal complex that has been used as an adjuvant treatment in clinics for the primary nephrotic syndrome(PNS)for many ***,the effectiveness and safety of HQH have not been systematically *** review aimed to evaluate the effectiveness and safety of HQH in paediatric patients with *** The following databases were searched from inception to Mar 2019:MEDLINE,Cochrane Library,EMBASE,CNKI,Wanfang Database,the Chinese Scientific Journal Database and the Chinese biomedical literature service *** the randomized controlled trials(RCTs)eligible for inclusion were *** primary outcomes were relapse,infection,remission and adverse *** secondary outcomes included serum immunoglobulin levels(IgA,IgG or IgM),T-lymphocyte subtype(CD3+,CD4+,CD8+,CD4+/CD8+),IL-10,TNF-α,TNF-γ,total cholesterol and time of proteinuria turning *** Fourteen RCTs(885 patients)were *** with HQH reduced the chance of relapse[relative risk(RR):0.47;95%CI:0.34,0.66;P<0.001]and infections(RR:0.47;95%Cl:0.35,0.62;P<0.001).No significant difference was found in adverse *** also increased the serum levels of IgA[weighted mean difference(WMD):0.40;95%Cl:0.20,0.60;P<0.001]and IgG(WMD:1.58;95%Cl:1.38-1.78;P<0.001),as well as CD4+[standard mean difference(SMD):0.90;95%Cl:0.12-1.68;P=0.02],CD3+(WMD:4.04;95% CI:3.27-4.82;P<0.001),and the CD4^(+)/CD8^(+)ratio(WMD:0.31;95% CI:0.21-0.41;P<0.001),but decreased the level of CD8+cells(WMD:-3.39;95% CI:-5.73-1.05;P=0.004).No statistically significant difference was found in IgM(WMD:0.05;95% CI:-0.13,0.24;P=0.57).Conclusions HQH could reduce the rate of relapse and the frequency of infection in children with *** apparent adverse effects were ***,the beneficial influence of HQH may act through *** multi-center,large-sample,high-quality studies are needed to confirm the effectiveness and safety of

关键词： Children Huaiqihuang Nephrotic syndrome Meta-analysis

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