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Normal renal growth in children with myelodysplasia
Insights
Children with spina bifida often have smaller kidneys than expected. This study found that renal length in these pediatric patients consistently fell below standard growth charts, particularly as they aged.
Area of Science:
- Pediatric Urology
- Nephrology
- Developmental Biology
Background:
- Optimal management of myelodysplasia in children requires monitoring upper tract anatomy and renal growth.
- Concerns exist regarding smaller kidney size in children with spina bifida compared to standard growth charts.
Purpose of the Study:
- To investigate the perception of reduced renal size in children with spina bifida without intrinsic renal disease.
- To compare renal length measurements in pediatric spina bifida patients against established renal growth charts.
Main Methods:
- Retrospective study of 212 children with spina bifida.
- Exclusion of patients with significant vesicoureteric reflux, congenital renal anomalies, hydronephrosis, scarring, or urinary diversion.
- Measurement of renal length on supine 5-minute excretory urograms for 95 neonates (2-19 days old).
Main Results:
- Mean renal length for each age group was below the mean of standard renal growth curves (Hodson and Currarino).
- The deviation from the mean increased with age in the studied pediatric population.
- Data analyzed from 249 urograms for 95 neonates.
Conclusions:
- Children with spina bifida, even without intrinsic renal disease, tend to exhibit smaller kidney sizes.
- Findings suggest a need for age-specific growth references for renal length in pediatric spina bifida patients.
- Periodic assessment of renal growth is crucial for the urologic management of children with myelodysplasia.
Abstract:
Optimum urologic management of children with myelodysplasia includes periodic assessment of upper tract anatomy and renal growth. To investigate the perception that many children with spina bifida but without a history of intrinsic renal disease have small kidneys when compared with age-matched standard renal growth charts, 212 children with spina bifida were studied retrospectively, measuring renal length on excretory urograms. Patients with known vesicoureteric reflux of grade 2 or greater, congenital renal anomalies, hydronephrosis, renal scarring, or urinary diversion were excluded. For 95 patients aged 2 days to 19 days, 249 urograms were available for evaluation. Renal lengths were measured on the supine 5-min urogram. Mean values and standard deviations were calculated for each age group. Mean renal length for each age group fell below the mean of the standard curves devised by Hodson and Currarino, with increasing deviation from the mean with age.