Related Experiment Video

Updated: Apr 18, 2026

A Mouse Model to Evaluate the Long-Term Structural and Functional Outcomes after the Reversal of Prolonged Unilateral Ureteric Obstruction
05:34

A Mouse Model to Evaluate the Long-Term Structural and Functional Outcomes after the Reversal of Prolonged Unilateral Ureteric Obstruction

Published on: July 18, 2025

636

Chronic Kidney Disease Stage Progression in Patients Undergoing Repair of Persistent Cloaca

W Robert DeFoor1, Andrea Bischoff1, Pramod Reddy1

  • 1Division of Pediatric Urology and Alberto Peña Colorectal Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

The Journal of Urology
|January 28, 2015
PubMed

Insights

Children with persistent cloaca can maintain kidney function after surgery. Aggressive bladder management is key to preventing further kidney damage in these complex pediatric cases.

Area of Science:

  • Pediatric Urology
  • Congenital Abnormalities
  • Nephrology

Background:

  • Persistent cloaca is a rare congenital anorectal malformation requiring complex surgical reconstruction.
  • Long-term complications include bladder dysfunction and chronic kidney disease (CKD).
  • Understanding upper urinary tract outcomes is crucial for managing these patients.

Purpose of the Study:

  • To evaluate upper urinary tract outcomes in children with persistent cloaca.
  • To assess the risk of chronic kidney disease (CKD) stage progression.
  • To identify factors influencing renal function in this population.

Main Methods:

  • Retrospective cohort study of 44 patients undergoing posterior sagittal anorecto-vagino-urethroplasty (PSARV) from 2006-2013.
  • Inclusion criteria: complete urological care at the institution.
  • CKD staging based on cystatin C or nuclear medicine GFR; median follow-up of 5.3 years.

Main Results:

  • 19 patients had hydronephrosis, 19 had vesicoureteral reflux, and 15 had tethered spinal cord.
  • 30 patients (68%) had neurogenic bladder, with 27 requiring clean intermittent catheterization.
  • 38 patients had stage I/II CKD, 5 had stage III, and 1 had stage IV. No stage progression observed in patients with initial stage I-III CKD.

Conclusions:

  • Patients with persistent cloaca and early-stage CKD (I-III) can maintain renal function post-reconstruction.
  • High rates of lower urinary tract dysfunction are common but manageable.
  • Proactive bladder management strategies are essential to prevent progressive renal injury.
Abstract

Keywords:
chroniccloacaglomerular filtration rateneurogenicrenal insufficiencyurinary bladder

More Related Videos

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats05:34

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats

Published on: April 4, 2025

2.0K
Unilateral Ureteral Obstruction Model for Investigating Kidney Interstitial Fibrosis04:37

Unilateral Ureteral Obstruction Model for Investigating Kidney Interstitial Fibrosis

Published on: April 25, 2025

1.9K

Related Concept Videos

Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
1.6K
Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
1.3K
Kidney Transplant II: Surgical Procedure01:26

Kidney Transplant II: Surgical Procedure

Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
872
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
652
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
521
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
2.1K