Total nephrectomy in children: a clinicopathological review
A S Adamson1, A S Nadjmaldin, J D Atwell
1Wessex Regional Centre for Paediatric Surgery, Southampton General Hospital.
British Journal of Urology
|November 1, 1992
Summary
Calculus disease presents a significant threat to pediatric kidneys, more so than common conditions like severe vesicoureteric reflux (VUR) or obstructive uropathy. This review highlights calculus disease as a severe risk factor in children undergoing nephrectomy.
Area of Science:
- Pediatric Nephrology
- Urology
- Pediatric Surgery
Background:
- Total nephrectomy in children is performed for various renal pathologies.
- Common indications include pyelonephritis, renal tumors, dysplasia, and obstructive uropathy.
- Understanding the underlying causes is crucial for management and prevention.
Purpose of the Study:
- To review the indications for total nephrectomy in children.
- To identify associated renal abnormalities in patients with pyelonephritis.
- To compare the severity of different etiological factors, particularly calculus disease.
Main Methods:
- Retrospective review of medical records for 85 children who underwent total nephrectomy.
- Analysis of diagnoses, including pyelonephritis, renal tumors, renal dysplasia, multicystic kidney, obstructive uropathy, and renal vein thrombosis.
- Detailed examination of associated abnormalities in the pyelonephritis group.
Main Results:
- Pyelonephritis was the most common indication (37 patients), with 36 showing ipsilateral abnormalities.
- Severe vesicoureteric reflux (VUR) was the most frequent abnormality in pyelonephritis cases.
- Calculus disease was present in 9 patients, posing a severe threat, with only one case associated with VUR.
Conclusions:
- Calculus disease represents a more severe threat to the pediatric kidney than VUR or obstructive uropathy.
- Early detection and management of calculus disease are critical in children.
- Further research into the long-term impact of calculus disease on renal health is warranted.
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