MILD AND MODERATE VESICOURETERIC REFLUX IN CHILDREN

儿童轻度和中度膀胱输尿管反流

基本信息

  • 批准号:
    3231291
  • 负责人:
  • 金额:
    $ 6.71万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    1983
  • 资助国家:
    美国
  • 起止时间:
    1983-09-30 至 1992-11-30
  • 项目状态:
    已结题

项目摘要

Renal injury from vesicoureteric reflux (VUR), or reflux nephropathy (RN), is a major cause of hypertension and end-stage renal disease and the only such cause which may be preventable. RN must have its onset in infancy or early childhood because renal scarring from VUR +UTI is observed rarely after childhood. While it is common to have renal scarring associated with severe grades of VUR, two prospective studies in children have found no benefit to early surgical correction of VUR over that of medical management. It has been assumed previously that mild and moderate (M/M) grades of VUR resolved spontaneously and were associated rarely with renal injury in the absence of UTI, but no such prospective study has been conducted to confirm this notion. Such a study was initiated 4 years ago with partial funding through NIH. The goals of the study are to observe over a 5 year follow-up period the evolution of M/M VUR by annual cystograms, to assess renal growth and injury by planimetric measurements from intravenous pyelograms at 1,3 and 5 years after diagnosis, to evaluate renal function by GFR, urinalysis and concentrating capacity, and to monitor blood pressure and measure plasma renin activity as predictors of hypertension in infants and young children < 5 years old at diagnosis and treated medically. When the study was closed to new patient entry, a total of 113 patients had been entered: 96 have completed first year, 59 second year and 21 third year follow up evaluations to date. While VUR improved or disappeared in 40% of ureters and only 2 previously normal kidneys had scars at 1 year (2/96 patients), 3 kidneys have scars and 5 others have exhibited poor growth or have evidence to suggest scarring at 3 years (8/21 patients); no relationship to the grade of VUR and scarring was observed in these patients. While all affected kidneys may be clustered in the first patients entered for the study, the importance of complete, long-term follow up of all patients is obvious. To accomplish this, the project must be funded adequately for 3 additional years. There has never been a similar prospective study of such a homogenous population with mild-moderate VUR. The conclusions of this study will either support current recommendations for conservative medical management of mild-moderate VUR in infants and young children or give reason to investigate management alternatives to reduce the incidence of serious consequences of a childhood disease which has its sequelae during adolescence and young adulthood.
膀胱输尿管反流(VUR)或反流性肾病(RN)引起的肾损伤, 是高血压和终末期肾病的主要原因, 这些原因是可以预防。RN必须在婴儿期发作,或 儿童早期,因为很少观察到VUR +UTI的肾瘢痕形成 在童年之后。虽然常见的是肾疤痕与 两项儿童前瞻性研究发现, VUR的早期手术矫正优于药物治疗 管理以前曾假设轻度和中度(M/M) VUR分级自发消退,很少与肾功能不全相关。 在没有UTI的情况下损伤,但没有这样的前瞻性研究, 来证实这一观点。这项研究始于4年前, 部分资金来自国家卫生研究院这项研究的目的是观察 在5年随访期内,M/M VUR的演变按年度 膀胱造影,通过平面测量评估肾脏生长和损伤 从诊断后1年、3年和5年的静脉肾盂造影中, 通过GFR、尿分析和浓缩能力测定肾功能, 监测血压和测量血浆肾素活性作为 诊断时< 5岁的婴幼儿高血压, 接受药物治疗 当研究结束时,共有113名患者 进入:96人完成第一年,59人完成第二年,21人完成第三年 迄今为止的年度后续评价。而VUR改善或消失, 1年时,40%的输尿管和仅2个先前正常的肾脏出现瘢痕 (2/96例患者),3个肾脏有瘢痕,5个肾脏表现出不良 3年时生长或有证据表明瘢痕形成(8/21例患者);无 在这些患者中观察到与VUR和瘢痕形成的等级的关系, 患者虽然所有受影响的肾脏可能聚集在第一个患者中, 进入研究,完整,长期随访的重要性 所有的病人都是显而易见的。要做到这一点,该项目必须得到资助。 再多三年就足够了。从来没有一个类似的 对轻度-中度VUR同质人群的前瞻性研究。 这项研究的结论将支持目前的建议, 用于婴儿轻中度VUR的保守医学管理, 幼儿或给予理由调查管理替代方案, 减少儿童疾病严重后果的发生率, 在青春期和青年期有后遗症。

项目成果

期刊论文数量(2)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Vesicoureteric reflux and renal injury.
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BILLY S ARANT其他文献

BILLY S ARANT的其他文献

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{{ truncateString('BILLY S ARANT', 18)}}的其他基金

PEDIATRIC NEPHROLOGY TRAINING
儿科肾脏病学培训
  • 批准号:
    3535817
  • 财政年份:
    1991
  • 资助金额:
    $ 6.71万
  • 项目类别:
NEONATAL RESPONSES TO ALTERATIONS IN PLASMA VOLUME
新生儿对血浆容量变化的反应
  • 批准号:
    3234788
  • 财政年份:
    1986
  • 资助金额:
    $ 6.71万
  • 项目类别:
NEONATAL RESPONSES TO ALTERATIONS IN PLASMA VOLUME
新生儿对血浆容量变化的反应
  • 批准号:
    3234789
  • 财政年份:
    1986
  • 资助金额:
    $ 6.71万
  • 项目类别:
NEONATAL RESPONSES TO ALTERATIONS IN PLASMA VOLUME
新生儿对血浆容量变化的反应
  • 批准号:
    3234790
  • 财政年份:
    1986
  • 资助金额:
    $ 6.71万
  • 项目类别:
MILD AND MODERATE VESICOURETERIC REFLUX IN CHILDREN
儿童轻度和中度膀胱输尿管反流
  • 批准号:
    3231285
  • 财政年份:
    1983
  • 资助金额:
    $ 6.71万
  • 项目类别:
MILD AND MODERATE VESICOURETERIC REFLUX IN CHILDREN
儿童轻度和中度膀胱输尿管反流
  • 批准号:
    3231290
  • 财政年份:
    1983
  • 资助金额:
    $ 6.71万
  • 项目类别:
COLLABORATIVE STUDIES OF PEDIATRIC RENAL DISEASE
小儿肾脏疾病的合作研究
  • 批准号:
    3231289
  • 财政年份:
    1983
  • 资助金额:
    $ 6.71万
  • 项目类别:
COLLABORATIVE STUDIES OF PEDIATRIC RENAL DISEASE
小儿肾脏疾病的合作研究
  • 批准号:
    3231287
  • 财政年份:
    1983
  • 资助金额:
    $ 6.71万
  • 项目类别:
COLLABORATIVE STUDIES OF PEDIATRIC RENAL DISEASE
小儿肾脏疾病的合作研究
  • 批准号:
    3231288
  • 财政年份:
    1983
  • 资助金额:
    $ 6.71万
  • 项目类别:
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