scholarly journals Anderson-Hynes Pyeloplasty in Children: Nonintubated Versus Intubated

2012 ◽  
Vol 35 (2) ◽  
pp. 59-61
Author(s):  
Gazi Zahirul Hasan ◽  
AKM Zahid Hossain ◽  
Md Ruhul Amin ◽  
Shafiqul Hoque ◽  
MTH Siddiqui
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection ◽  
Hospital Stay ◽  
Paediatric Surgery ◽  
Dhaka City ◽  
Additional Advantage ◽  
Differential Renal Function ◽  
Medical University

Objective: To compare between nonintubated versus intubated Anderson-Hynes (AH) pyeloplasty in children.Study Design: Prospective studyStudy place: Department of Paediatric Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh and some private clinics of Dhaka city. Study period: March 2001 to December 2008.Subjects: A total of 75 patients were included in this study. They were divided in two groups. Nonintubated Anderson-Hynes pyeloplasty was done in 45 patients and intubated Anderson-Hynes pyeloplasty was done in 30 patients.Results: The anastomotic leakage of urine, urinary tract infection, hospital stay and improvement of differential renal function were assessed post operatively in both nonintubated and intubated groups. This study showed that there was no anastomotic failure and no post operative urinary tract infection in either group. The percentage of improvement of differential renal function is almost same in both the groups. The post operative hospital stay was markedly reduced in nonintubated Anderson-Hynes pyeloplasty. In this study the post operative hospital stay in nonintubated group was average 6 days and it was average 16.5 days in intubated group.Conclusion: From this study it may be concluded that the effects of nonintubated AH pyeloplasty is as good as intubated one but an additional advantage of significantly less post operative hospital stay was observed in nonintubated group.DOI: http://dx.doi.org/10.3329/bjch.v35i2.10378  Bangladesh J Child Health 2011; Vol 35 (2): 59-61

scholarly journals Comparison of 99mTc- Ethylene Dicysteine and 99mTc-Dimercaptosuccinic Acid Scintigraphy for the Evaluation of Cortical Scarring and Differential Renal Function in Children with Recurrent Urinary Tract Infection

2012 ◽  
Vol 46 (4) ◽  
pp. 183-186
Author(s):  
KLN Rao ◽  
BR Mittal ◽  
Senthil Raja ◽  
Vipul Pareek ◽  
Baljinder Singh ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection ◽  
Recurrent Urinary Tract Infection ◽  
Left Kidney ◽  
Linear Regression Analysis ◽  
Dimercaptosuccinic Acid ◽  
Differential Renal Function ◽  
Dimercaptosuccinic Acid Scintigraphy

ABSTRACT Introduction Urinary tract infection (UTI) is the most common and severe bacterial infection in children. Renal scarring and associated deterioration in the differential renal function is a frequent finding. Scarring may occur even in asymptomatic patients without vesicoureteric reflux. Materials and methods Fifty-three children (43 M:10 F, mean age:5.3 years; range 2-10 years) with evidence of recurrent UTI were enrolled in the study. Patients with duplex or crossed fused ectopic kidneys and with acute or chronic renal failure were excluded from the study protocol. Each patient underwent 99mTc-DMSA and 99mTc-EC renal scintigraphy within a period of 2 weeks. Results Analysis of results was performed by comparing the diagnostic accuracy of the summed 99mTc-EC and 99mTc-DMSA images for the detection of renal cortical scars and correlation (linear regression analysis) between the two renal scintigraphic procedures for the estimation of differential renal function. 99mTc-DMSA imaging demonstrated scarring in 41 kidneys whereas 99mTc-EC scintigraphy revealed scarring in 29/41 kidneys only. The percentage function of both kidneys with 99mTc-EC and 99mTc-DMSA showed good correlation. The r2 for left kidney was 0.95 and for right kidney was 0.94. Conclusion 99mTc-EC scintigraphy has low sensitivity (70%) for the detection of cortical scarring as compared to 99mTc-DMSA (100%) renal imaging. On the hand, 99mTc-DMSA static imaging gives good estimate for the DRF and the values are in good agreement with the corresponding values derived from dynamic 99mTc-EC scanning. How to cite this article Raja S, Pareek V, Singh B, Sharma S, Rao KLN, Mittal BR. Comparison of 99mTc-Ethylene Dicysteine and 99mTc-Dimercaptosuccinic Acid Scintigraphy for the Evaluation of Cortical Scarring and Differential Renal Function in Children with Recurrent Urinary Tract Infection. J Postgrad Med Edu Res 2012;46(4):183-186.

scholarly journals Delayed Fever and Acute Kidney Injury in Patients with Urinary Tract Infection

2020 ◽  
Vol 9 (11) ◽  
pp. 3486
Author(s):  
Kun-Lin Lu ◽  
Chih-Yen Hsiao ◽  
Chao-Yi Wu ◽  
Chieh-Li Yen ◽  
Chung-Ying Tsai ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection ◽  
Hospital Stay ◽  
Kidney Injury ◽  
Lower Baseline ◽  
Clinical Awareness ◽  
Baseline Renal Function

The presence of fever has long been a warning sign of severe urinary tract infection (UTI). However, we previously identified that inpatients with afebrile UTI had an increased risk of developing acute kidney injury (AKI). After expanding this cohort, 1132 inpatients with UTI diagnosed between January 2006 and April 2019 were analyzed. Overall, 159 (14%) of these patients developed AKI; bacteremia, urolithiasis, septic shock, hypertension, lower baseline renal function, marked leukocytosis, and the absence of fever were independently linked to AKI. When we further studied the cohort of inpatients with fever during hospitalization, we identified a group of “delayed fever” UTI inpatients who did not have fever as their initial presentation. Compared to patients presenting with fever at the emergency department, patients with delayed fever tended to be younger and have less frequent infection with Escherichia coli, more frequent AKI, upper tract infection, and a longer hospital stay. Despite the initial absence of fever, these patients demonstrated larger extents of elevations in both serum white blood cell counts and C-reactive protein levels. In short, besides UTI patients with lower baseline renal function that remain afebrile during their hospital stay, clinical awareness of the increased incidence of AKI in younger patients with “delayed fever” should also be noted.

scholarly journals Population Pharmacokinetic and Pharmacokinetic/Pharmacodynamic Analyses of Cefiderocol, a Parenteral Siderophore Cephalosporin, in Patients with Pneumonia, Bloodstream Infection/Sepsis, or Complicated Urinary Tract Infection

2020 ◽  
Author(s):  
Nao Kawaguchi ◽  
Takayuki Katsube ◽  
Roger Echols ◽  
Toshihiro Wajima
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection ◽  
Bloodstream Infection ◽  
Plasma Concentrations ◽  
Complicated Urinary Tract Infection ◽  
Population Pharmacokinetic ◽  
Dosing Regimen ◽  
Population Pk

Cefiderocol is a novel siderophore cephalosporin with antibacterial activity against Gramnegative bacteria including carbapenemresistant strains. The standard dosing regimen of cefiderocol is 2 g administered every 8 hours over 3 hours infusion in patients with creatinine clearance (CrCL) of 60 to 119 mL/min, and it is adjusted for patients with < 60 mL/min or ≥ 120 mL/min CrCL. A population pharmacokinetic (PK) model was constructed using 3427 plasma concentrations from 91 uninfected subjects and 425 infected patients with pneumonia, bloodstream infection/sepsis (BSI/sepsis), and complicated urinary tract infection (cUTI). Plasma cefiderocol concentrations were adequately described by the population PK model, and CrCL was the most significant covariate. No other factors including infection sites and mechanical ventilation were clinically relevant, although the effect of infection sites was identified as a statistically significant covariate in the population PK analysis. No clear pharmacokinetic/pharmacodynamic relationship was found for any of the microbiological outcome, clinical outcome, or vital status. This is because the estimated percentage of time for which free plasma concentrations exceed the minimum inhibitory concentration (MIC) over dosing interval (%fT>MIC) was 100% in most of the enrolled patients. The probability of target attainment (PTA) for 100% fT>MIC was > 90% against MICs ≤ 4 μg/mL for all infection sites and renal function groups except for BSI/sepsis patients with normal renal function (85%). These study results support adequate plasma exposure can be achieved at the cefiderocol recommended dosing regimen for the infected patients including the patients with augmented renal function, ventilation, and/or severe illness.

scholarly journals Renal Function 16 to 26 Years After the First Urinary Tract Infection in Childhood

2000 ◽  
Vol 154 (4) ◽  
pp. 339 ◽  
Author(s):  
Martin Wennerström ◽  
Sverker Hansson ◽  
Ulf Jodal ◽  
Rune Sixt ◽  
Eira Stokland
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection

Renal function in adult women with urinary tract infection in childhood

2015 ◽  
Vol 30 (9) ◽  
pp. 1493-1499 ◽  
Author(s):  
Carin Gebäck ◽  
Sverker Hansson ◽  
Jeanette Martinell ◽  
Torsten Sandberg ◽  
Rune Sixt ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection ◽  
Adult Women

scholarly journals Outcome of Exernal and Internal Drainage of Urine after Anderson Hynes Pyeloplasty - A Comparative Study

2013 ◽  
Vol 2 (1) ◽  
pp. 22-25
Author(s):  
AM Shahinoor ◽  
MMR Shibli ◽  
MAB Akan ◽  
M Anisuzzaman ◽  
MN Islam ◽  
...  
Keyword(s):  
Renal Function ◽  
Hospital Stay ◽  
Postoperative Hospital Stay ◽  
Paediatric Surgery ◽  
Nephrostomy Tube ◽  
Split Renal Function ◽  
Unilateral Hydronephrosis ◽  
Group A ◽  
Group B ◽  
Medical University

Background: Hydronephrosis in children is a common abnormality of the kidney. Surgical intervention in patient with hydronephrosis is to improve urinary drainage and to preserve renal function. Surgery (Anderson Hynes pyeloplasty: A-H pyeloplasty ) can be done with or without (Nephrostomy tube) D-J stent.Here we are describing our comparative experience between A-H pyeloplasty with D-J stent and A-H pyeloplasty with nephrostomy tube, at Bangabandhu Sheikh Mujib Medical University(BSMMU) to show the postoperative advantages of the former over the latter. Objectives: To assess functional outcome after A-H pyeloplasty with or without D-J stent in patients of unilateral hydronephrosis. Post operatively renal function was estimated after 3 months by DTPA renogram. Methods: It was a prospective study at Paediatric Surgery department of Bangabandhu Sheikh Mujib Medical University from April 2009 to October 2010. Twenty eight ( age, sex, side and type of operation matched) patients of unilateral hydronephrosis were included in the study and divided into two Groups: Group A (na =15) and Group B (nb=13) patients who underwent A-H pyeloplasty with D-J stent and A-H pyeloplasty with nephrostomy tube respectively. Child with bilateral hydronephrosis, hydronephrosis with associated anomalies like horseshoe kidney, ectopic kidney, solitary kidney, hydronephrosis with vesico ureteric reflux and redopyeloplasty were excluded in this study. Unpaired “t” test and Chi-square test were used for statistical analysis whereas postoperative hospital stay and renal functional improvement were used as parameters of the study. Results: For study Group A (A-H pyeloplasty with D-J stent) postoperative hospital stay were significantly lesser (P<0.00) than the GroupB ( A-H pyeloplasty with nephrostomy tube). Post operative split renal function and glomerular filtration rate (GFR) in Group A was improved (percentage) than Group B. Conclusion: This study reveals postoperative shorter hospital stay and improved postoperative split renal function in A-H pyeloplasty with D-J stent. DOI: http://dx.doi.org/10.3329/jpsb.v2i1.15159 Journal of Paediatric Surgeons of Bangladesh (2011) Vol. 2 (1): 22-25

Extended Therapy in Patients with Established Urinary Tract Infection

1971 ◽  
Vol 16 (3) ◽  
pp. 169-172
Author(s):  
D. H. Lawson ◽  
R. I. Gleadle ◽  
A. L. Linton
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection ◽  
Recurrence Rate ◽  
Impaired Renal Function ◽  
Renal Damage ◽  
Initial Therapy ◽  
Intravenous Pyelography ◽  
Acute Urinary Tract Infection

Sixty-six patients with established urinary tract infection were given a 3-month course of antibacterial therapy and the effect of this upon the recurrence rate of urine infections investigated. Even in patients with no radiological evidence of renal damage the recurrence rate was 40 per cent at 2 years and this rose to 75 per cent in the group with impaired renal function and abnormalities present on intravenous pyelography. It is concluded that an initial 10 day course of therapy is indicated in females suffering from their first or second attack of acute urinary tract infection. If this becomes established, a 3-month course of therapy is suggested and following this, further recurrences demand careful renal investigation. In the male, all cases of urinary tract infection should be investigated after the initial therapy. Finally, the management of those patients with no anatomical lesion who suffer from recurrent attacks of infection after a 3-month course of therapy has not yet been clearly defined. There is no evidence that either ampicillin, nitrofurantoin or nalidixic acid is superior to sulphadimidine in the treatment of patients with established urinary tract infection.

scholarly journals Usefulness of Transurethral Incision as a Primary Treatment of Ureterocele in Children

1996 ◽  
Vol 2 (4) ◽  
pp. 189-196 ◽  
Author(s):  
Ichiro Takeuchi ◽  
Katsuya Nonomura ◽  
Koichi Kanagawa ◽  
Tetsufumi Yamashita ◽  
Hidehiro Kakizaki ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Renal Function ◽  
Urinary Tract ◽  
Tract Infection ◽  
De Novo ◽  
Primary Treatment ◽  
Single System ◽  
Normal Kidney ◽  
Duplex System ◽  
Transurethral Incision

Seventeen patients (11 girls and 6 boys, with bilateral cases in 4 for a total 21 units), in whom ureterocele was diagnosed at from 5 days to 11 years old, were treated with transurethral incision as a primary treatment. Urinary tract infection was the most common presenting sign in 8 patients. A voiding disturbance was observed in 10 patients. Seven units were diagnosed as intravesical ureteroceles of a single system and 14 units as ectopic ones (12 associated with the duplex system and 2 with a single system). De novo reflux occurred in 12 units, but in 5 units resolved spontaneously. All 5 refluxes in mate units improved, and 2 refluxes in the contralateral ureter also disappeared. The control of infection became easy in all patients except for one with a sphincteric ureterocele. Split renal function on T99mc-diethylenetriamine pentaacetic acid scintigraphy was prominently improved in 5 systems (35.7%) and normal kidney growth was obtained in 11 systems (78.6%). A total of 13 affected units (68.4%), including 7 units (6 intravesical and 1 ectopic) for which transurethral incision seemed to have been the sole necessary treatment, were saved. We believe that transurethral incision of ureteroceles is a very useful technique as a primary treatment for all types of ureteroceles in children of all ages.

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