The urological and nephrological analysis of children with renal ectopia

Öz

Background: To assess the morphological and clinical features of children with renal ectopia (RE) and assess whether the lateralization of ectopia determines the prognosis. Methods: The clinical, laboratory and radiological data of 61 patients diagnosed as RE in our center between the years of 2004 and 2014 were retrospectively reviewed. Results: There were 32 girls (52.5%) and 48 boys (47.5%). The median age was 48 (2-204) months and follow-up time was 60 (2-120) months. RE was right-sided in 33 (54%) and left-sided in 26 (46%) patients. 52 patients (85.2%) had simple RE whereas 9 (14.8%) had crossed RE. 27 children (44.3%) had additional urinary abnormality, 15 (24.6%) had extra-renal disease. The most common urinary tract malformation was vesicoureteral reflux (VUR) (21%). Renal scarring (RS) was detected in 17 patients (27.9%) on DMSA scan. 32 patients (52.5%) experienced urinary tract infection (UTI), 5 (8.2%) had hypertension, 11 (11%) had proteinuria, 5 (8%) had chronic renal disease (CKD). No significant difference was found between ectopia sides for development of additional urinary or systemic disease, UTI, proteinuria, hypertension and CKD (p> 0.05). Conclusion: The children with RE should be carefully examined for additional urinary or systemic abnormalities. Voiding cystourethrogram might be recommended in those patients for the increased risk of VUR. The patients with RE should be closely followed-up for avoiding long term complications including proteinuria, hypertension and CKD because of susceptibility to UTI and RS. The lateralization of ectopia might not affect the incidence of additional abnormality or late complications.

Anahtar Kelimeler

• Renal ectopia, children, ectopia side, prognosis

Renal ektopili çocukların ürolojik ve nefrolojik analizi

Öz

Amaç: Renal ektopi (RE)\'nin morfolojik ve klinik özelliklerini, ektopi lateralizasyonunun prognozu etkileyip etkilemediğini değerlendirmek. Yöntemler: Merkezimizde 2004-2014 yılları arasında RE tespit edilen 61 pediatrik hastanın klinik, laboratuvar ve görüntüleme sonuçları retrospektif olarak gözden geçirildi. Bulgular: Hastaların 32\'si kız (%52,5), 29\'u erkek (%47,5), yaş ortalaması 48 (2-204) ay, takip süresi 60 (2-120) aydı. RE 33 hastada (%54) sağ, 26 hastada (%46) sol yerleşimliydi. 52 hastada (%85,2) basit RE, 9 hastada (%14,8) çapraz RE tespit edildi. 27 hastada (%44.3) ek üriner anomali, 15\'inde (%24.6) ek hastalık mevcuttu. En sık görülen üriner sistem bozukluğu vezikoüreteral reflü (VUR) (%21) idi. DMSA sintigrafisinde 17 hastada (%27,9) renal skar (RS) tespit edildi. Takiplerde 32 hastada (%52.5) idrar yolu enfeksiyonu (İYE), 5\'inde (%8,2) hipertansiyon, 11\'inde (%11) proteinüri ve 5\'inde (%8) kronik böbrek hastalığı (KBH) görüldü. Hastalar ektopi lokalizasyonuna göre karşılaştırıldığında ek üriner ve sistemik anomali, İYE, RS, hipertansiyon, proteinüri ve KBH gelişim riski açısından sağ ve sol taraflar arasında istatiksel açıdan anlamlı fark saptanmadı (p> 0,05). Sonuç: RE\'li çocuklar ek üriner ve sistemik hastalık açısından dikkatle incelenmelidir. Artmış VUR riski nedeniyle bu hastalara voiding sistoüretrografi çekilmesi önerilebilir. RE\'de İYE ve RS\'a yatkınlık yüksek olup proteinüri, hipertansiyon ve KBH gibi uzun dönem komplikasyonların ortaya çıkışını önlemek için hastalar yakından takip edilmelidir. Ektopi lateralizasyonu ek hastalık insidansını ve geç komplikasyonları etkilemeyebilir.

Anahtar Kelimeler

• Renal ektopi, çocuk, ektopi tarafı, prognoz

Kaynakça

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