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膀胱外翻-尿道上裂综合征的长期肾脏预后:成年患者的表现

Long-term Kidney Outcomes in Exstrophy-Epispadias Complex: How Patients Present as Adults.

作者信息

Handa Nicole, Bowen Diana K, Guo Jenny, Chu David I, Kielb Stephanie J

机构信息

Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.

Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Urology, Department of Surgery, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.

出版信息

Urology. 2021 Aug;154:333-337. doi: 10.1016/j.urology.2021.01.033. Epub 2021 Jan 29.

Abstract

OBJECTIVE

To characterize kidney function in patients with exstrophy-epispadias complex (EEC) at time of presentation for adult urologic care.

MATERIALS AND METHODS

This was a retrospective analysis of 23 patients (ages 18-57) with EEC who presented to a single tertiary care center from 2001-2020. Kidney function was evaluated based on calculated eGFR and presence of hydronephrosis on imaging. UDS data was used to evaluate the bladder.

RESULTS

Patients had undergone a variety of different surgical techniques for exstrophy or epispadias repair prior to presentation to an adult urologist. We found that 10 of the 23 patients had evidence of CKD Stage II or higher at the time of presentation and 7 patients had evidence of hydronephrosis on imaging. There was urodynamics data available for 14 patients, of which 8 patients showed poor (≤15 ml/cmHO) or intermediate (15-20 ml/cmHO) bladder compliance.

CONCLUSION

In conclusion, some patients with EEC have evidence of kidney dysfunction at time of presentation to an adult urologist. It is important to consider this when caring for patients with EEC as adults.

摘要

目的

描述膀胱外翻-尿道上裂复合畸形(EEC)患者在接受成人泌尿外科治疗时的肾功能情况。

材料与方法

这是一项对2001年至2020年期间在单一三级医疗中心就诊的23例(年龄18 - 57岁)EEC患者的回顾性分析。根据计算的估算肾小球滤过率(eGFR)和影像学上肾积水的情况评估肾功能。使用尿动力学数据评估膀胱。

结果

患者在就诊于成人泌尿外科医生之前已经接受了各种不同的手术技术进行膀胱外翻或尿道上裂修复。我们发现,23例患者中有10例在就诊时存在慢性肾脏病(CKD)II期或更高分期的证据,7例患者在影像学上有肾积水的证据。有14例患者可获得尿动力学数据,其中8例患者表现出膀胱顺应性差(≤15 ml/cmH₂O)或中等(15 - 20 ml/cmH₂O)。

结论

总之,一些EEC患者在就诊于成人泌尿外科医生时存在肾功能不全的证据。在照料成年EEC患者时考虑到这一点很重要。

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