title: Renal recoverability in infants with obstructive calcular anuria: is it better than in older children?
abstract: OBJECTIVE
  Urolithiasis in infants can cause considerable morbidity. The literature regarding calcular anuria in this age group is very defective. Our aim was to evaluate impact of intervention on renal recoverability in these infants.
  
  
  METHODS
  A series of 24 patients presenting with obstructive calcular anuria were included in this study. Mean age was 16.5 ± 6.2 months. They were treated either by initial urinary diversion or definitive endoscopic (ureteroscopy or JJ stenting with medical alkalinization) or open surgical (ureterolithotomy or pyelolithotomy) treatment.
  
  
  RESULTS
  Mean serum creatinine was 5.8 ± 2.6 mg/dl. Initial peritoneal dialysis and/or urinary diversion was needed in 11 patients (45.8%). Open surgical treatment was applied in 5 (20.8%), endoscopic treatment was applied in 15 (62.5%), while combined treatment was applied in 4 (16.6%) patients. All patients had normal serum creatinine on discharge. Three (12.5%) had residual stones which were cleared by 2ry ureteroscopic intervention at 6 months. The overall complication rate in this study was 12.5% in the form of postoperative leakage (1) and postoperative fever (2). No mortality or development of chronic renal failure was reported at 6 months follow up. In comparison with these results, a previous study carried out in our centre on an older age group had a higher complication rate (28%) with higher mortalities and lower renal function recoverability rate (94%).
  
  
  CONCLUSIONS
  Appropriate and timely medical and surgical management of calcular anuria will mostly lead to full recovery of renal functions. In comparison with older children, renal prognosis in those less than 2 years seems more favorable.
authors.affiliation: Division of Pediatric Urology, Aboul-Riche Children's Hospital, Cairo University, Cairo, Egypt.
authors.forename: Sameh
authors.initials: S
authors.lastname: Kotb
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: ElSheemy
authors.forename: Hany A
authors.initials: HA
authors.lastname: Morsi
authors.forename: Tamir
authors.initials: T
authors.lastname: Zakaria
authors.forename: Mohamed
authors.initials: M
authors.lastname: Salah
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Eissa
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000601:surgery / Q000628:therapy; D000367:Age Factors; D001002:Anuria / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery / Q000628:therapy; D008297:Male; D009403:Nephrostomy, Percutaneous; D010530:Peritoneal Dialysis; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D020127:Recovery of Function; D015607:Stents; D013812:Therapeutics; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*; D014547:Urinary Diversion; D052878:Urolithiasis / Q000150:complications / Q000601:surgery*
keywords: Anuria; Calculi; Infants; Obstructive nephropathy; Renal recoverability