Üriner sistem anomalisi tespit edilen çocukların klinik ve demografik özellikleri

Öz

Amaç: Bu çalışmada üriner sistem ultrasonografisi ile saptanan böbrek anomalisi bulunan çocukların klinik ve demografik özelliklerinin değerlendirilmesi amaçlanmıştır.

Materyal ve Metot: Hastanemizde ultrasonografi ile üriner sistem anomalisi saptanan ve bir yıllık izleminde ileri incelemeler yapılmış olan çocukların tıbbi kayıtları retrospektif olarak incelendi.

Bulgular: Çalışmaya yaşları 0-17 yaş arasında, 179’u (%55.1) erkek toplam 325 hasta alındı. En sık gözlenen üriner sistem anomalisi 103 (%31.7) hastada saptanan üretero-pelvik darlık idi. Diğer tespit edilen anomaliler hastaların 82’sinde (%25.2) vezikoüreteral reflü, 33’ünde (%10.2) renal hipoplazi, 30’unda (%9.2) çift toplayıcı sistem, 18’inde (%5.5) posterior üretral valv, 14’ünde (%4.3) üretero-vezikal darlık, 13’ünde (%4.0) renal agenezi, 13’ünde (%4.0) ektopik böbrek, 11’inde (%3.4) at nalı böbrek ve 8’inde (%2.5) multikistik displastik böbrek olarak belirlendi. Beş hastada böbrek yetmezliği ve 10 hastada hipertansiyon mevcuttu.

Sonuç: Üriner sistem anomalisi saptanan çocukların gelişebilecek komplikasyonların belirlenmesi, renal hasarın saptanması ve eşlik eden ek anormalliklerin değerlendirilmesi açısından yakından izlemleri gerekmektedir. 

Anahtar Kelimeler

• Çocuk,Üriner sistem anomalisi,Renal hasar,Vezikoüreteral reflü

Clinical and demographic characteristics of children with urinary tract anomaly detected

Öz

Background: The aim of this study was to evaluate the clinical and demographic characteristics of children with renal anomaly detected by urinary system ultrasonography.

Methods: The medical records of children with urinary system anomalies detected by ultrasonography in our hospital and who underwent further investigations in one year follow-up were examined retrospectively.

Results: A total of 325 patients were included in the study, the ages of between 0-17 years, 179 (55.1%) of them males. The most common urinary system anomaly was uretero-pelvic junction obstruction in 103 (31.7%) patients. Other detected anomalies were vesicoureteral reflux in 82 (25.2%) patients, renal hypoplasia in 33 (10.2%), double collecting system in 30 (9.2%), posterior urethral valve in 18 (5.5%), in 14 ( 4.3%) uretero-vesical junction obstruction, 13 (4.0%) renal agenesis, 13 (4.0%) ectopic kidney, 11 (3.4%) horseshoe kidney, and 8 (2.5%) as multicystic dysplastic kidney determined. Five patients had renal failure and 10 patients had hypertension.

Conclusion: It is necessary to follow up closely to determine the complications that may occur in children with urinary tract anomalies, to detect renal damage and to evaluate the additional abnormalities.

 

Keywords: Child, Urinary tract anomaly, Renal damage, Vesicoureteral reflux.

Anahtar Kelimeler

• Child,Urinary tract anomaly,Renal damage,Vesicoureteral reflux

Kaynakça

1. 1. Riccabona M. Imaging of the neonatal genito-urinary tract. Eur J Radiol. 2006 Nov;60(2):187-98. Epub 2006 Sep 7. PMID: 16959460
2. 2. Kuhn JP, Slovis TL, Haller JO (eds). Caffey's Pediatric Diagnostic Imaging, 10th ed., vol. 2, Philadelphia, Mosby, 2004, p 2365
3. 3. Rosenblum ND, Salomon R. Disorders of kidney formation. In: Geary DF, Schaefer F (eds). Comprehensive Pediatric Nephrology. Mosby-Elsevier, Philadelphia, 2008; 132-141.
4. 4. Yosypiv IV. Congenital anomalies of the kidney and urinary tract: a genetic disorder? Int J Nephrol. 2012;2012:909083. doi: 10.1155/2012/909083. Epub 2012 May 20. PMID: 22685656
5. 5. Keller G, Zimmer G, Mall G, Ritz E, Amann K. Nephron number in patients with primary hypertension. N Engl J Med 2003; 348: 101-8. PMID: 12918529
6. 6. Fernbach SK, Feinstein KA, Schmidt MB. Pediatric voiding cystourethrography: a pictorial guide. Radiographics. 2000 Jan-Feb;20(1):155-68; discussion 168-71. Review. PMID: 10682779 DOI: 10.1148/radiographics.20.1.g00ja12155
7. 7. Morris RK, Kilby MD. Congenital urinary tract obstruction. Best Pract Res Clin Obstet Gynaecol. 2008;22:97–122. PMID: 17904905
8. 8. Şimşek F, Tinay İ. Çocuklarda üreteropelvik bileşke obstrüksiyonları. Klinik Gelişim 2008;21:24-27.].

9. 9. Becker AM. Postnatal evaluation of infants with an abnormal antenatal renal sonogram. Curr Opin Pediatr 2009;21:207-213]. PMID: 19663038
10. 10. Yürük Yıldırım ZN, Congenital Malformations Of Kidney. J Child. 2013; 13(4): 141-146. doi:10.5222/j.child. 2013.141.
11. 11. Doğan ÇS, Torun-Bayram M, Aybar MD. Unilateral multicystic dysplastic kidney in children. Turk J Pediatr. 2014 Jan-Feb;56(1):75-9.). PMID: 24827951
12. 12. Kaneko K, Suzuki Y, Fukuda Y, Yabuta K, Miyano T. Abnormal contralateral kidney in unilateral multicystic dysplastic kidney disease. Pediatr Radiol 1995;25:275-277. PMID: 7567236
13. 13. Elmaci AM, Akın F. Konjenital böbrek ve üriner kanal anomalisi bulunan çocukların klinik ve demografik özellikleri. Dicle Medical Journal 2014; 41 (2): 309-312. doi: 10.5798/diclemedj.0921.2014.02.0422.
14. 14. Guarino N, Tadini B, Camardi P, Silvestro L, Lace R, Bianchi M. The incidence of associated urological abnormalities in children with renal ectopia. J Urol 2004;172:1757-9. http://dx.doi.org/10.1097/01.ju.0000138376.93343.74. PMID: 15371807
15. 15. Calisti A, Perrotta ML, Oriolo L, Ingianna D, Miele V. The risk of associated urological abnormalities in children with pre and postnatal occasional diagnosis of solitary, small or ectopic kidney: is a complete urological screening always necessary? World J Urol. 2008 Jun;26(3):281-4. doi: 10.1007/s00345-008-0249-0. Epub 2008 Mar 29. PMID: 18373095
16. 16. Farrugia MK. Fetal bladder outlet obstruction: Embryopathology, in utero intervention and outcome. J Pediatr Urol. 2016 Oct; 12(5):296-303. doi: 10.1016/j.jpurol.2016.05.047. PMID: 27570093
17. 17. Grigoris C, Kousidis. Posterior Urethral Valve; Essential in Pediatric Urology; 2012; 115-124). Research Signpost 37/661 (2), Fort P.O. Trivandrum-695 023 Kerala, India
18. 18. Renjen P1, Bellah R, Hellinger JC, Darge K. Advances in uroradiologic imaging in children. Radiol Clin North Am. 2012 Mar;50(2):207-18 doi: 10.1016/j.rcl.2012.02.003. PMID: 22498439
19. 19. Nakanishi K, Yoshikawa N. Genetic disorders of human congenital anomalies of the kidney and urinary tract (CAKUT). Pediatr Int 2003; 45: 610–616). PMID: 14521546