[Measurement of health-related quality of life in children with chronic kidney disease using a specific test. Influence of treatment]. / Medida mediante un test específico de la calidad de vida relacionada con la salud en niños con enfermedad renal crónica. Influencia del tratamiento.

INTRODUCTION: Chronic kidney disease (CKD) affects the daily life of the child especially during the stage where their personal development takes place. Adult renal patients have a demonstrated worse health related quality of life (HRQL) mainly under hemodialysis (HD), however there are few published data about HRQL in children with CKD, most of them obtained after patient s childhood or with generic tests that do not discriminate changes in a specific disease. OBJECTIVE: To assess how our patients perceive their health by measuring the HRQL and its most affected domains. To determine how the different therapies affect the child with CKD and the agreement on the opinion between children and their parents. MATERIAL AND METHODS: We included 71 CKD children and their parents in a cross-sectional study (33 transplanted, 11 peritoneal dialysis [PD], 5 HD, 22 conservative treatment). We used a specific quality of life test for CKD children that we had previously developed (TECAVNER). If the child was younger than 9 years, only their parents completed the survey. RESULTS: children on HD refer a worse HRQL followed by those who underwent PD and those transplanted. The best HRQL was obtained in children with conservative treatment. Both parents and children agree that the domains more frequently affected are physical activity and school attendance especially those on HD. The way the adolescents 15 years and older perceived their health was similar to that of their parents. This was not the case in the younger group, 9 through 15 ears.

Desarrollo de un cuestionario en español de medida de calidad de la vida en pacientes pediátricos con enfermedad renal crónica / Design of a quality of life questionnaire in Spanish for children with chronic kidney disease

El tratamiento actual de la enfermedad renal crónica en la infancia debe incluir los aspectos sociales y psicológicos implicados en la calidad de vida del niño y de su familia. Nuestro objetivo ha sido desarrollar un instrumento de medida específico de la calidad de vida de los pacientes pediátricos con enfermedad renal crónica en español, ya que no existe actualmente ninguno validado para niños. Hemos desarrollado un cuestionario en español específico para enfermedad renal en niños basado en el test de calidad de vida para adultos con enfermedad renal (KDQOL-SFTM) y en el test de calidad de vida para niños con epilepsia (CAVE) adaptándolos a niños con enfermedad renal, al que denominamos TECAVNER (Test de Calidad de Vida en Niños con Enfermedad Renal). La fiabilidad de dicho cuestionario, determinada por el coeficiente alfa Cronbach, fue de 0,92. Las limitaciones del estudio consisten en que no se ha realizado validez de constructo ni test-retest. En conclusión, este trabajo constituye un primer intento para diseñar un cuestionario específico de calidad de vida relacionada con la salud en español para niños con enfermedad renal crónica (AU)

Treatment of chronic kidney disease in childhood must include assessment of social and psychological aspects involved in the perceived quality of life of the child and its family. Our objective has been to design a specific tool in Spanish for measuring quality of life in pediatric patients with chronic kidney disease, since there is not a validated test for children at the moment. Results: We designed a specific questionnaire for kidney disease in children based on the test of quality of life for adults with kidney disease (KDQOL-SFTM) and on the test of quality of life for children with epilepsy (CAVE)adapting them to children with kidney disease, denominating TECAVNER (Test of Quality of Life in Children with Kidney Disease). Reliability of this questionnaire determined by alfa Cronbach coefficient was 0,92. Limitations: questionnaire determined by Test-retest reliability and construct validity were not conducted. In conclusion, this is a first approach for design a specific health related quality of life test in Spanish for children with chronic kidney disease (AU)

Medida mediante un test específico de la calidad de vida relacionada con la salud en niños con enfermedad renal crónica. Influencia del tratamiento / Measurement of health related quality of life in children with chronic kidney disease using a specific test. Influence of treatment

Introducción: La enfermedad renal crónica (ERC) modifica la vida del paciente y afecta de manera especial a los niños en su etapa de desarrollo personal. En adultos se ha demostrado peor calidad de vida relacionada con la salud(CVRS), sobre todo en hemodiálisis (HD); sin embargo, hay muy pocos datos objetivos sobre CVRS en niños con ERC, la mayoría obtenidos una vez superada la infancia de estos enfermos o con cuestionarios genéricos que no permiten discriminar cambios en una enfermedad específica. Objetivos: Conocer cómo perciben nuestros pacientes su estado de salud midiendo la CVRS y sus áreas más afectadas. Determinar la influencia de los distintos tratamientos y la concordancia entre la opinión de los niños y de sus padres. Material y métodos: Estudio transversal en 71 niños(33 sometidos a trasplante, 11 en diálisis peritoneal, cinco en HD y 22 en tratamiento conservador) y en sus padres. Utilizamos un cuestionario específico desarrollado por nosotros para la medida de CVRS en niños con ERC. En los menores de 9 años sólo contestaron los padres. Resultados: Los niños en HD refieren una peor CVRS, seguidos de los pacientes en diálisis peritoneal (DP) y de los sometidos a trasplante (TX), y la mejor CVRS se obtiene en los pacientes sometidos a tratamiento conservador. Los aspectos que más se ven alterados son la actividad física y la asistencia escolar, sobre todo en HD, hecho en el que coinciden padres e hijos. La concordancia entre padres e hijos fue buena en los mayores de 15 años, existiendo discordancia en los niños de 9 a 15 años (AU)

Introduction: Chronic kidney disease (CKD) affects the daily life of the child especially during the stage where their personal development takes place. Adult renal patients have a demonstrated worse health related quality of life (HRQL)mainly under hemodialysis (HD), however there are few published data about HRQL in children with CKD, most of them obtained after patient´s childhood or with generic tests that do not discriminate changes in a specific disease. Objetive: To assess how our patients perceive their health by measuring the HRQL and its most affected domains. To determine how the different therapies affect the child with CKD and the agreement on the opinion between children and their parents. Material and methods: We included 71CKD children and their parents in a cross-sectional study ( 33transplanted, 11 peritoneal dialysis [PD], 5 HD, 22conservative treatment). We used a specific quality of life test for CKD children that we had previously developed(TECAVNER). If the child was younger than 9 years, only their parents completed the survey. Results: Children on HD refer a worse HRQL followed those who underwent PD and those transplanted. The best HRQL was obtained in children with conservative treatment. Both parents and children agree that the domains more frequently affected are physicalactivity and school attendance especially those on HD. The way the adolescents 15 years and older perceived their health was similar to that of their parents. This was not the case in the younger group, 9 through 15 years (AU)

Calidad de vida percibida por niños con enfermedad renal crónica y por sus padres / Perceived quality of life in children with chronic renal disease and in their parents

Introducción: La enfermedad renal crónica (ERC) afecta al bienestar físico, psíquico y social del niño. En adultos y adolescentes se ha descrito una peor calidad de vida (CV)en enfermos renales que en población sana, pero hay pocos estudios con instrumentos de medida de CV en niños con enfermedad renal. Objetivo: Estudiar la CV de los niños con ERC y compararla con un grupo control de niños sanos. Material y métodos: Estudio transversal en 71 niños con ERC y 57 sanos utilizando el cuestionario de salud generalMOS-SF-20 en mayores de 9 años y sus padres o sólo en éstos en los menores de 9 años. Resultados: Los niños con ERC tienen peor CV que los niños sanos con diferencia significativa en la percepción de la función física, del rol físico y del estado general de la salud y no significativa en la socialización. Los niños enfermos refieren menos dolor y mejor bienestar emocional que los niños sanos. La calidad percibida por los padres es también peor en la población de niños enfermos que en la de niños sanos en todos los dominios excepto en el dolor. La CV percibida por los padres coincide en todos los dominios con la de los niños de 9 a 12 años e infravalora la función social y el bienestar emocional en los niños mayores de 12 años. Conclusiones: La CV en niños con ERC es peor que en niños sanos y afecta sobre todo al ámbito físico y a la salud general, en lo que coinciden niños y padres (AU)

Introduction: Chronic renal disease (CRD) affects physical, emotional and social wellbeing of children. Renal adult and adolescent patients have a poorer quality of life (QL) than healthy population but few studies have been performed in children with CRD and appropriate QL measurement tools. Objectives: To assess QL in children with CRD comparing it with healthy children. Material and methods: Cross-sectional study in 71 children with CRD and 57 healthy children with the generic health status tool MOSF-SF-20 answered by children older than 9 and their parents and only by parents when children were younger than 9. Results: Children with CRD have a poorer QL than healthy children with significant differences in general self-esteem, physical performance and physical activity and no significant difference in socialization. On the contrary they refer less pain and emotional discomfort than healthy population. Perceived QL of children by parents is also worse in CRD population affecting all but pain dominions. 9-12 years old children and their parents agree in all QL dominions while parents underestimate social function and emotional well-being when their children were older than 12. Conclusions: QL in children with CRD is worse than in healthy children mainly in physical function and general self esteem and agree with parents perceptions (AU)

[Design of a quality of life questionnaire in Spanish for children with chronic kidney disease]. / Desarrollo de un cuestionario en español de medida de calidad de la vida en pacientes pediátricos con enfermedad renal crónica.

UNLABELLED: Treatment of chronic kidney disease in childhood must include assessment of social and psychological aspects involved in the perceived quality of life of the child and its family. Our objective has been to design a specific tool in Spanish for measuring quality of life in pediatric patients with chronic kidney disease, since there is not a validated test for children at the moment. RESULTS: We designed a specific questionnaire for kidney disease in children based on the test of quality of life for adults with kidney disease (KDQOL-SFTM) and on the test of quality of life for children with epilepsy (CAVE) adapting them to children with kidney disease, denominating TECAVNER (Test of Quality of Life in Children with Kidney Disease). Reliability of this questionnaire determined be alfa Cronbach coefficient was 0,92. LIMITATIONS: Questionnaire determined by Test-retest reliability and construct validity were not conducted. In conclusion, this is a first approach for design a specific health related quality of life test in Spanish for children with chronic kidney disease.

[Perceived quality of life in children with chronic renal disease and in their parents]. / Calidad de vida percibida por niños con enfermedad renal crónica y por sus padres.

INTRODUCTION: Chronic renal disease (CRD) affects physical, emotional and social wellbeing of children. Renal adult and adolescent patients have a poorer quality of life (QL) than healthy population but few studies have been performed in children with CRD and appropriate QL measurement tools. OBJECTIVES: To assess QL in children with CRD comparing it with healthy children. MATERIAL AND METHODS: Cross-sectional study in 71 children with CRD and 57 healthy children with the generic health status tool MOSF-SF-20 answered by children older than 9 and their parents and only by parents when children were younger than 9. RESULTS: Children with CRD have a poorer QL than healthy children with significant differences in general self-esteem, physical performance and physical activity and no significant difference in socialization. On the contrary they refer less pain and emotional discomfort than healthy population. Perceived QL of children by parents is also worse in CRD population affecting all but pain dominions. 9-12 years old children and their parents agree in all QL dominions while parents underestimate social function and emotional well-being when their children were older than 12. CONCLUSIONS: QL in children with CRD is worse than in healthy children mainly in physical function and general self-esteem and agree with parents perceptions.

Biopsia renal en pediatría / Renal biopsy in pediatrics

No disponible

Pautas de detección, prevención y tratamiento de la nefropatía diabética en España / Guidelines of detection, prevention and treatment of diabetic nephropathy in Spain

No disponible

[Lymphocele after renal transplantation: therapeutic controversies in the age of laparoscopy]. / Linfocele postrasplante renal: controversias terapéuticas en la era de la laparoscopia.

We present 11 lymphoceles in 180 consecutive kidney transplants (6%). We study the potential etiologic factors, symptoms, diagnostic evaluation and treatment, stressing the role of laparoscopy in management of bulky and loculated symptomatic lymphoceles. This technique allows to reduce morbidity, increasing efficacy and shortening hospitalization.

[Neonatal pelvic ectasia]. / Ectasia piélica en período neonatal.

54 neonates found to have pelvic dilatation on sonography are reported. They were studied by IVP, voiding cystography and renal function tests. Periodic sonography, urine cultures and DPTA furosemide in severe cases were performed during the follow-up (3-32 months). The ectasias were classified in 4 grades, found a good correlation with urography in grades I, III and IV. Neonatal pelvic dilatation is associated with: 1) urinary tract infection (17.4%); 2) vesicoureteric reflux (25.5%); 3) ureteropelvic obstruction (17.4%). During the follow-up 52% of ectasia disappeared (x: 6 months) and 11% will required pieloplasty (x: 10 months). It is noteworthy the high rate of initial and further urinary tract infection (53% of patients).