Miklovicova Daniela, Cervenova Olga, Cernianska Andrea, Jancovicova Zuzana, Dedik Ladislav, Vasilenkova Alena
1st Department of Pediatrics, University Children's Hospital, Comenius University in Bratislava, Bratislava, Slovakia.
Pediatr Nephrol. 2008 Jun;23(6):937-45. doi: 10.1007/s00467-007-0741-6.
In this prospective study, selected biochemical markers of glomerular and tubular function, proteinuria, and ultrasound findings in 62 pediatric patients who underwent surgery for obstructive uropathy were examined. Patients were younger than 12 months, normocreatininemic at the time of surgery, and examined at a mean age of 6.3+/-0.9 years. Out of the markers tested, serum concentration of cystatin C was significantly higher in patients when compared with the control group (p<0.001), and serum creatinine concentration was within reference interval in all patients. With respect to tubular function, 26% of patients had decreased concentration ability. Proteinuria was detected in 4.8% of patients. On ultrasound, 66.7% of kidneys after surgery had residual dilatation of the renal pelvis. The patients thrive well, and their somatic parameters do not differ from their peers. Half of the patients had one or more urinary tract infections from the date of surgery to the date of examination. Study results support the need for long-term nephrologic follow-up in patients after surgery for obstructive uropathy. The hypothesis that renal function in patients undergoing surgery aged younger than 3 or 6 months is better when compared with those aged 6 to 12 months has not been confirmed.
在这项前瞻性研究中，对62例因梗阻性尿路病接受手术的儿科患者的肾小球和肾小管功能、蛋白尿的选定生化标志物以及超声检查结果进行了检测。患者年龄小于12个月，手术时血肌酐正常，平均检查年龄为6.3±0.9岁。在所检测的标志物中，患者的胱抑素C血清浓度与对照组相比显著升高（p<0.001），且所有患者的血清肌酐浓度均在参考区间内。关于肾小管功能，26%的患者浓缩能力下降。4.8%的患者检测到蛋白尿。超声检查显示，66.7%的患者术后肾脏肾盂有残余扩张。患者生长良好，其身体参数与同龄人无异。从手术日期到检查日期，一半的患者发生过一次或多次尿路感染。研究结果支持对梗阻性尿路病手术后的患者进行长期肾脏随访的必要性。与6至12个月龄的患者相比，3或6个月龄以下接受手术的患者肾功能更好这一假设未得到证实。
