Objective:To look for change in relative renal function and document renal scarring following endoscopic renal pelvic instillation sclerotherapy(RPIS)in patients with chyluria by dimercaptosuccinic acid(DMSA)renal sca...Objective:To look for change in relative renal function and document renal scarring following endoscopic renal pelvic instillation sclerotherapy(RPIS)in patients with chyluria by dimercaptosuccinic acid(DMSA)renal scan.Methods:A prospective study was performed between November 2015 and September 2016.All patients with biochemically documented chyluria who underwent RPIS using either 1%-silver nitrate or 0.1%-povidine iodine were included.Patients received either 3-,6-or 9-doses.DMSA renal scan was performed before and 2e3 months after sclerotherapy.Results:Of the 34 patients,22 were males.Mean age was 41.08±16.64 years(range,15-70 years).Thirty-two patients(94.1%)responded to therapy while two did not respond even after 9-doses.Average follow-up was 8.94±3.70 months.The mean relative renal function(preinstillation)of normal kidney was 50.76%±3.55%while that of affected renal unit(side of instillation)was 49.20%±3.44%(range,43.0%-61.0%).After instillation therapy,the mean relative renal function of normal side was 52.26%±3.57%while that of affected renal unit was 47.50%±3.56%(range,41.0%-54.0%).The relative renal function did not change>5%from the baseline value in any patient except one(in which the differential function increased paradoxically by 12%).Two patients developed renal scar in post-instillation renal scan.Conclusion:Endoscopic sclerotherapy in chyluria is safe and effective.The relative renal function does not deteriorate by more than 5%.There is a small risk of development of renal scar.More studies involving larger number of patients are needed to answer this dilemma.展开更多
膀胱输尿管反流(vesicoureteral reflux,VUR)是小儿常见的泌尿系统异常,受到国内外学者的广泛关注,特别是VUR导致的不可逆性肾瘢痕,国内外对其危险因素以及预防措施的研究颇多,尤其是2007年膀胱输尿管反流随机化干预(randomized interve...膀胱输尿管反流(vesicoureteral reflux,VUR)是小儿常见的泌尿系统异常,受到国内外学者的广泛关注,特别是VUR导致的不可逆性肾瘢痕,国内外对其危险因素以及预防措施的研究颇多,尤其是2007年膀胱输尿管反流随机化干预(randomized intervention for children with vesicoureteral reflux,RIVUR)试验结束后,相关试验与统计研究的结果相继发表,在评估预防性口服抗生素对于初次泌尿道感染(urinary tract infection,UTI)后诊断VUR儿童的治疗有效性,以及VUR患儿肾瘢痕形成的危险因素等方面,提出了新的观点与思考。本文就VUR导致肾瘢痕发生的危险因素,以及预防性口服抗生素治疗的研究进展进行综述。展开更多
文摘Objective:To look for change in relative renal function and document renal scarring following endoscopic renal pelvic instillation sclerotherapy(RPIS)in patients with chyluria by dimercaptosuccinic acid(DMSA)renal scan.Methods:A prospective study was performed between November 2015 and September 2016.All patients with biochemically documented chyluria who underwent RPIS using either 1%-silver nitrate or 0.1%-povidine iodine were included.Patients received either 3-,6-or 9-doses.DMSA renal scan was performed before and 2e3 months after sclerotherapy.Results:Of the 34 patients,22 were males.Mean age was 41.08±16.64 years(range,15-70 years).Thirty-two patients(94.1%)responded to therapy while two did not respond even after 9-doses.Average follow-up was 8.94±3.70 months.The mean relative renal function(preinstillation)of normal kidney was 50.76%±3.55%while that of affected renal unit(side of instillation)was 49.20%±3.44%(range,43.0%-61.0%).After instillation therapy,the mean relative renal function of normal side was 52.26%±3.57%while that of affected renal unit was 47.50%±3.56%(range,41.0%-54.0%).The relative renal function did not change>5%from the baseline value in any patient except one(in which the differential function increased paradoxically by 12%).Two patients developed renal scar in post-instillation renal scan.Conclusion:Endoscopic sclerotherapy in chyluria is safe and effective.The relative renal function does not deteriorate by more than 5%.There is a small risk of development of renal scar.More studies involving larger number of patients are needed to answer this dilemma.
文摘膀胱输尿管反流(vesicoureteral reflux,VUR)是小儿常见的泌尿系统异常,受到国内外学者的广泛关注,特别是VUR导致的不可逆性肾瘢痕,国内外对其危险因素以及预防措施的研究颇多,尤其是2007年膀胱输尿管反流随机化干预(randomized intervention for children with vesicoureteral reflux,RIVUR)试验结束后,相关试验与统计研究的结果相继发表,在评估预防性口服抗生素对于初次泌尿道感染(urinary tract infection,UTI)后诊断VUR儿童的治疗有效性,以及VUR患儿肾瘢痕形成的危险因素等方面,提出了新的观点与思考。本文就VUR导致肾瘢痕发生的危险因素,以及预防性口服抗生素治疗的研究进展进行综述。
