Alteración genética no descrita previamente en 2 pacientes pediátricas con síndrome de Alport. Influencia pronóstica del genotipo / New mutation in 2 pediatric patients with Alport syndrome. Prognostic significance of genotype

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Nefritis intersticial aguda por ibuprofeno en población pediátrica / Ibuprofen-induced acute interstitial nephritis in the paediatric population

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Mycobacterium fortuitum como causa de infección del orificio del catéter de diálisis peritoneal. Caso clínico y revisión de la literatura / Mycobacterium fortuitum as a cause of peritoneal dialysis catheter port infection. A clinical case and a review of the literature

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The influence of clinical situation on health-related quality of life in paediatric chronic kidney disease patients.

BACKGROUND: Studies examining health-related quality of life (HRQOL) in adults with chronic kidney disease (CKD) have demonstrated that certain clinical situations such as number of hospitalisations and anaemia can affect patient quality of life. Very few such studies have been carried out in children. OBJECTIVE: To analyse the impact of laboratory variables and various clinical situations on HRQOL of paediatric CKD patients. PATIENTS AND METHOD: We carried out a cross-sectional study using the TECAVNER questionnaire in 71 children with CKD and their parents (33 transplanted patients, 11 on peritoneal dialysis, 5 on haemodialysis, and 22 on conservative treatment). We analysed laboratory variables (blood urea nitrogen, creatinine, haematocrit, and albumin), clinical situation (short stature, arterial hypertension, and bone deformities), number of hospitalisations, and days spent in the hospital in the previous 6 months, as well as number of drugs administered and fluids/diet restrictions. RESULTS: The factor that most heavily affected the quality of life of our patients was water restrictions. In addition, hypertension affected cognitive function in these children. A haematocrit value >35% improved physical activity and functionality. We observed no association between albumin and HRQOL. CONCLUSIONS: These results confirm previous hypotheses and contribute to the validity of the TECAVNER questionnaire.

Influencia de la situación clínica en la calidad de vida relacionada con la salud de los pacientes pediátricos con enfermedad renal crónica / The influence of clinical situation on health-related quality of life in paediatric chronic kidney disease patients

Antecedentes: Estudios sobre la calidad de vida relacionada con la salud (CVRS) en adultos con enfermedad renal crónica (ERC) han demostrado que situaciones clínicas como el número de ingresos o la anemia afectan a su calidad de vida. Existen muy pocos estudios similares en niños. Objetivo: Analizar el impacto de variables analíticas y de la situación clínica en la CVRS de los pacientes pediátricos con ERC. Pacientes y métodos: Estudio transversal utilizando el cuestionario TECAVNER en 71 niños con ERC y en sus padres (33 trasplantados, 11 en diálisis peritoneal, 5 en hemodiálisis, 22 en tratamiento conservador). Se analizaron variables analíticas (nitrógeno ureico en sangre, creatinina, hematocrito, albúmina) y situación clínica (talla baja, hipertensión arterial [HTA], deformidades óseas), número de ingresos y días de ingreso en los seis meses previos a la realización del estudio, así como número de fármacos administrados, restricción de líquidos o dieta. Resultados: uno de los factores que más distorsiona la calidad de vida de nuestros pacientes es la restricción hídrica. La HTA afecta a la función cognitiva de los niños. El hematocrito superior a un 35 % mejora la función y la actividad física. No encontramos relación entre valores de albúmina y CVRS. Conclusiones: Estos resultados confirman las hipótesis previas y contribuyen a dar validez al cuestionario TECAVNER (AU)

Background: Studies examining health-related quality of life (HRQOL) in adults with chronic kidney disease (CKD) have demonstrated that certain clinical situations such as number of hospitalisations and anaemia can affect patient quality of life. Very few such studies have been carried out in children. Objective: To analyse the impact of laboratory variables and various clinical situations on HRQOL of paediatric CKD patients. Patients and Method: We carried out a cross-sectional study using the TECAVNER questionnaire in 71 children with CKD and their parents (33 transplanted patients, 11 on peritoneal dialysis, 5 on haemodialysis, and 22 on conservative treatment). We analysed laboratory variables (blood urea nitrogen, creatinine, haematocrit, and albumin), clinical situation (short stature, arterial hypertension, and bone deformities), number of hospitalisations, and days spent in the hospital in the previous 6 months, as well as number of drugs administered and fluids/diet restrictions. Results: The factor that most heavily affected the quality of life of our patients was water restrictions. In addition, AHT affected cognitive function in these children. A haematocrit value >35% improved physical activity and functionality. We observed no association between albumin and HRQOL. Conclusions: These results confirm previous hypotheses and contribute to the validity of the TECAVNER questionnaire (AU)

Cadaver donor kidney retransplantation in the pediatric patient: complications and long-term outcome.

PURPOSE: We compared the outcome of second and third kidney allografts with that of the first kidney allograft in pediatric recipients. MATERIALS AND METHODS: We classified 173 cadaveric kidney recipients into 2 groups. Group 1 comprised 120 first transplants and group 2 comprised 53 retransplants, including 43 second and 10 third transplants. We compared demographic characteristics and survival in groups 1 and 2. RESULTS: Group 1 consisted of 78 boys and 42 girls with a mean ± SD age of 11.5 ± 4.2 years. Group 2 consisted of 37 boys and 16 girls with a mean age of 10.4 ± 4.7 years. One, 5, 10 and 15-year graft survival rates were 78.7%, 64.3%, 54.5% and 50.7% for first transplants vs 82.8%, 57.8%, 57.8% and 41.3%, respectively, for retransplants (p = 0.757). Patient survival at 1, 5 and 15-year was 95.8%, 89.6%, 84.9% in the first transplant group vs 93.6%, 93.6% and 93.6%, respectively, in the retransplant group (p = 0.0.63). Graft survival was significantly higher in patients who did vs did not receive calcineurin inhibitors in the 2 groups (p = 0.02). CONCLUSIONS: Kidney retransplantation in the pediatric population can yield excellent long-term outcomes, especially in patients treated with calcineurin inhibitors.

[Results of the use of donors under 3 years of age for pediatric renal transplantation]. / Resultados de la utilización de donantes de edad inferior a 3 años en trasplante renal pediátrico.

OBJECTIVES: To evaluate the functional results and incidence of complications in a series of pediatric renal transplants using grafts from pediatric donors under 3 years of age. METHODS: We review a serious of 19 renal transplants consecutively performed in pediatric receptors with donors under the age of 3 years. We analyze immediate function, medical and surgical complications, and long and mid-term graft and patient survivals. RESULTS: We observed initial graft dysfunction in 9 patients (47.4%). Six patients had vascular complications (31.5%). More vascular complications appeared in kidneys preserved with EC solution (35.3%) in comparison with UW solution (23.5%) (p < 0.05). 1, 5, 10, and 12 year actuarial graft survivals were 57.8%, 41.4%, 35.5% and 35.5%, respectively. Based on preservation solution, 1, 5, and 10 year actuarial graft survivals for EC were 44%, 33% and 16%, respectively; results improved with UW solution up to 60%, 50%, and 50% respectively (p < 0.001). CONCLUSIONS: Kidneys from donors under the age of the 3 years in pediatric receptors suffer a high incidence of vascular complications offering a low graft survival on the long-term, being these facts more evident when simpler preservation solutions are employed.