Can baseline serum creatinine and e-GFR predict renal function outcome after augmentation cystoplasty in children?
Int. braz. j. urol
; 44(1): 156-162, Jan.-Feb. 2018. tab, graf
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| ID: biblio-892941
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ABSTRACT
ABSTRACT Objective To assess cut-off value of creatinine and glomerular filtration rate for augmentation cystoplasty (AC) in paediatric age-group. Materials and Methods Data of all paediatric-patients (<18 years) with small capacity bladder, in whom AC was advised between 2005-2015 were reviewed. All patients were divided in two-groups, AC-group and control-group (without AC). Creatinine and e-GFR were assessed at the time of surgery, at 6 months and at last follow-up. Renal function deterioration was defined as increase in creatinine by ≥25% from baseline value or new-onset stage-3 CKD or worsening of CKD stage with pre-operative-CKD stage-3. ROCs were plotted using creatinine and e-GFR for AC. Results A total of 94 patients with mean-age 8.9 years were included. The mean creatinine and e-GFR were 1.33mg/dL and 57.68mL/min respectively. Out of 94 patients, AC was performed in 45 patients and in the remaining 49 patients AC was not done (control-group), as they were not willing for the same. Baseline patient's characteristics were comparable in both Groups. 22 underwent gastro-cystoplasty (GC) and 25 underwent ileo-cystoplasty (IC). Decline in renal function was observed in 15 (33.3%) patients of AC-group and in 31 (63.3%) patients of control-group. Patients having creatinine ≥1.54mg/dL (P=0.004, sensitivity (S) 63.6% and specificity (s) 90.5%) at baseline and e-GFR ≤46mL/min (P=0.000, S=100% and s=85.7%) at the time of surgery had significantly increased probability of renal function deterioration on follow-up after AC. Conclusion e-GFR ≤46mL/min and creatinine ≥1.54mg/dL at time of surgery could serve as a predictor of renal function deterioration in AC in paediatric patients.
Texte intégral:
1
Indice:
LILACS
Sujet Principal:
Procédures de chirurgie urologique
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Maladies de la vessie
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Créatinine
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Débit de filtration glomérulaire
Type d'étude:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limites du sujet:
Adolescent
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Child
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Female
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Humans
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Male
langue:
En
Texte intégral:
Int. braz. j. urol
Thème du journal:
UROLOGIA
Année:
2018
Type:
Article