title: Study of kidney damage in paediatric patients with neurogenic bladder and its relationship with the pattern of bladder function and treatment received.
abstract: OBJECTIVE
  Kidney failure is the main cause of morbidity and mortality in patients with myelodysplasia. We analysed the presence of renal lesions in these patients using dimercaptosuccinic acid scintigraphy and related their presence with the type of vesical function and the delay in receiving appropriate management.
  
  
  METHODS
  We performed a retrospective study of patients with myelodysplasia treated in our hospital since 2004. We analysed the epidemiological and clinical data and the pattern of bladder function according to urodynamic studies. We classified the patients into 4 urodynamic patterns according to detrusor and sphincter behaviour. We linked this behaviour to renal function in the scintigraphy and the care received since birth.
  
  
  RESULTS
  The study included 39 patients with myelodysplasia. The most common bladder pattern was type A (61.5%), with sphincter and detrusor hyperactivity, followed by type D (20.5%), C (7.8%) and B (5.1%). Some 38% of our patients (n=15) had some type of nephropathy. Some 92.9% of the children who were properly treated during the first year of their life had no renal lesions in the scintigraphy. We found some type of nephropathy in 56% of the patients for whom appropriate treatment was delayed for more than a year. The nephropathy was more severe the later the management was started.
  
  
  CONCLUSIONS
  There is a statistically significant relationship between a delay in treatment and impairment in renal scintigraphy in patients with neurogenic bladders. The early study and treatment of patients is essential for decreasing renal impairment, reducing the need for surgery and improving the continence options.
authors.affiliation: Servicio de Cirugía Pediátrica, Complexo Hospitalario Universitario de A Coruña, La Coruña, España. Electronic address: maria.rodriguez.ruiz@sergas.es.
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez-Ruiz
authors.affiliation: Servicio de Cirugía Pediátrica, Complexo Hospitalario Universitario de A Coruña, La Coruña, España.
authors.forename: I
authors.initials: I
authors.lastname: Somoza
authors.affiliation: Servicio de Cirugía Pediátrica, Complexo Hospitalario Universitario de A Coruña, La Coruña, España.
authors.forename: N
authors.initials: N
authors.lastname: Curros-Mata
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000209:etiology*; D008297:Male; D012189:Retrospective Studies; D001750:Urinary Bladder, Neurogenic / Q000150:complications* / Q000503:physiopathology / Q000628:therapy
keywords: Función renal; Neurogenic bladder; Renal function; Urodinámica; Urodynamic; Vejiga neurógena