Dogan Cagla Serpil, Dorterler Mustafa Erman, Aybar Mustafa Devran, Ciftci Halil, Gulum Mehmet, Akin Yigit, Yeni Ercan
Division of Pediatric Nephrology, Sanliurfa Children's Hospital, Sanliurfa, Turkey.
Department of Pediatric Surgery, University of Harran, Sanliurfa, Turkey.
Saudi J Kidney Dis Transpl. 2017 Mar-Apr;28(2):330-335. doi: 10.4103/1319-2442.202787.
Urological anomalies can be seen in children with renal ectopia (RE) and can result in renal impairment. Therefore, we evaluated associated anomalies and renal outcome in our patients with RE. Sixty-eight children who were diagnosed with RE between January 2009-May 2014 were retrospectively studied. A total of 68 patients, 36 (52.9%) boys, with a median age of 67 months (4-201) and a median follow-up period of 14 months (3-113) were included in the study. Simple RE (S-RE) was found in 51 (75%) patients, of which 46 were unilateral and five were bilateral (discoid kidney). Crossed RE (C-RE) was detected in 17 (25%) patients. Voiding cystourethrogram was performed in 21/51 (41.2%) patients in S-RE group and 5/17 (29.4%) in C-RE group. We did not find vesicoureteral reflux (VUR) in any of the patients with C-RE, whereas, in S-RE group, VUR was demonstrated in six (6/21 - 28.6%) patients. Pelviureteric junction obstruction in ectopic kidney was found in two patients with S-RE and one with C-RE. Two patients (2/17 - 11.7%) had neurogenic bladder due to meningomyelocele, accompanied by imperforate anus in C-RE group. There were no significant differences in other associated urological anomalies between two groups. Renal impairment developed mostly in patients with additional urinary anomaly. The children with RE may have associated urinary anomalies, of which VUR is the most common. Complete urological investigation and regular follow-up are required in selected cases.
肾异位(RE)患儿可出现泌尿系统异常,进而导致肾功能损害。因此,我们评估了我院RE患儿的相关异常情况及肾脏预后。对2009年1月至2014年5月期间诊断为RE的68例患儿进行回顾性研究。本研究共纳入68例患者,其中36例(52.9%)为男性,中位年龄67个月(4 - 201个月),中位随访时间14个月(3 - 113个月)。51例(75%)患者为单纯性肾异位(S - RE),其中46例为单侧,5例为双侧(盘状肾)。17例(25%)患者为交叉性肾异位(C - RE)。S - RE组51例患者中有21例(41.2%)进行了排尿性膀胱尿道造影,C - RE组17例患者中有5例(29.4%)进行了此项检查。C - RE组所有患者均未发现膀胱输尿管反流(VUR),而S - RE组有6例(6/21 - 28.6%)患者出现VUR。S - RE组有2例患者、C - RE组有1例患者的异位肾存在肾盂输尿管连接处梗阻。2例(2/17 - 11.7%)患者因脊髓脊膜膨出导致神经源性膀胱,C - RE组患者伴有肛门闭锁。两组其他相关泌尿系统异常情况无显著差异。肾功能损害主要发生在合并其他泌尿系统异常的患者中。RE患儿可能伴有泌尿系统异常,其中VUR最为常见。部分病例需要进行全面的泌尿系统检查及定期随访。