Renal deterioration in myelodysplastic children: urodynamic evaluation and clinical correlates

The Journal of Urology
E A Kurzrock, S Polse

Abstract

We determined which factors portend a higher risk of renal deterioration in the myelodysplastic child, and evaluated the sensitivity and predictive value. We retrospectively reviewed the medical history, imaging studies and urodynamics of 90 children with spinal dysraphism. Median patient age at initial evaluation was 3 months and average followup ranged between 2 and 25 years (average 11). We evaluated the relation of urodynamic parameters and sex to upper tract changes and the resolution of these changes. Statistically significant relationships were identified between the urodynamic parameters of leak point pressure, compliance and detrusor-sphincter dyssynergia, and renal deterioration but not with resolution of deterioration. Boys and girls did not demonstrate a significant difference among urodynamic parameters. Female patients had a higher incidence of reflux and parenchymal loss. With knowledge of the inherent sensitivity, specificity and predictive value of urodynamic parameters, selective use of urodynamics will assist in identifying patients at risk of renal deterioration. Female patients with reflux are at greatest risk of parenchymal loss. We advocate early institution of intermittent catheterization in patients ide...Continue Reading

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Citations

Oct 11, 2008·World Journal of Urology·Eric A Kurzrock
Dec 21, 2007·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Carla Verpoorten, Gunnar M Buyse
Mar 14, 2013·International Urology and Nephrology·Yan MaXiaomin Han
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Aug 18, 2004·The Journal of Urology·Suzanne E GeneraoEric A Kurzrock
Sep 8, 2010·The Journal of International Medical Research·M-L CongT-H Jia
Mar 17, 2016·World Journal of Nephrology·Maximilien BaronJean-Nicolas Cornu
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Sep 4, 2018·International Journal of Nephrology·Helen J Sims-WilliamsBenjamin C Warf

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