Is there any relation between connective tissue growth factor and scar tissue in vesicoureteral reflux?

Is there any relation between connective tissue growth factor and scar tissue in vesicoureteral reflux? Turk J Pediatr. 2019;61(1):71-78 Authors: Gültekin ND, Benzer M, Tekin-Neijmann Ş Abstract Gültekin ND, Benzer M, Tekin-Neijmann Ş. Is there any relation between connective tissue growth factor and scar tissue in vesicoureteral reflux. Turk J Pediatr 2019; 61: 71-78. Vesicoureteral reflux (VUR) is the most common uropathy in childhood which leads to increased frequency of urinary tract infection (UTI) and renal scarring. Connective tissue growth factor (CTGF) plays an important role in the development of glomerular and tubulointerstitial fibrosis in progressive kidney diseases. The aim of this study was to investigate the relation between urinary CTGF and renal damage resulted from VUR. This cross sectional study included 70 patients with VUR and 62 healthy sex and age matched children. Urinary creatinine and CTGF (uCTGF) concentrations were analysed in all cases and CTGF to creatinine ratio were calculated. The records of radiologic evaluations of the patients including ultrasound, voiding cystouretrography and 99m-technetium dimercaptosuccinic acid (DMSA) scintigraphy were obtained retrospectively. The patient group was further divided into two groups according to the existence of renal cortical scarring in the DMSA scan. The study consisted of three groups; Group 1 (control group) 62 children, Group 2 (VUR positive, scar negative) 24 pat...
Source: The Turkish Journal of Pediatrics - Category: Pediatrics Authors: Tags: Turk J Pediatr Source Type: research

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Conclusions: First UTI in a group of Thai children occurred in approximately equal proportion in boys and girls but boys were younger at diagnosis. Kidney and urinary tract anomalies were detected in half of the children.Urol Int
Source: Urologia Internationalis - Category: Urology & Nephrology Source Type: research
ConclusionsIn older children, the normal late DMSA scan predicted the absence of high-grade VUR, obviating the need for a VCUG. This approach could be a possible strategy for children not studied at acute infection time.
Source: Indian Journal of Pediatrics - Category: Pediatrics Source Type: research
CONCLUSIONS: CIC can be deferred until continence in select infants with a low risk of significant DMSA abnormality. However, immediate initiation of CIC upon recognition of risk factors is recommended as this was associated with fewer DMSA abnormalities than delaying CIC. Recommendations for expectantly-managed patients include close follow-up, serial US and UD, and prompt initiation of CIC upon recognition of new hydronephrosis, reflux, elevated storage pressures, or febrile UTIs. PMID: 29125524 [PubMed - as supplied by publisher]
Source: Journal of Pediatric Rehabilitation Medicine - Category: Rehabilitation Tags: J Pediatr Rehabil Med Source Type: research
Conclusion: In routine clinical practice, DMSA SPECT scintigraphy can demonstrate renal abnormalities in approximately one-tenth of pediatric patients with hypertension who do not have a known history of urinary tract infection, vesicoureteral reflux, or known secondary cause for hypertension. The prevalence of renal scarring appears to be lower with a more stringent expert imaging review. Future studies may help identify patients for whom performing DMSA scintigraphy will be most informative and help guide decisions regarding further evaluation. Research Support: -
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Renal/Hypertension Source Type: research
AbstractThe primary goal in the management of a child with urinary tract infection (UTI) is to prevent recurrence of UTI and acquired renal damage. Approximately 15% of children develop renal scarring after a first episode of febrile UTI. Vesico-ureteric reflux (VUR) is diagnosed in 30 –40% of children imaged after first febrile UTI. The ‘top-down’ approach involving ultrasound and dimercaptosuccinic acid scan (DMSA) first after an appropriate interval following UTI, can help in avoiding voiding cystourethrogram (VCUG), an invasive test with higher radiation exposure. The ma jority view remains that VCUG ...
Source: Indian Journal of Pediatrics - Category: Pediatrics Source Type: research
CONCLUSIONS: Neither the renal ultrasound nor the DMSA scan is accurate enough to detect VUR (of all grades). Although a child with a negative DMSA test has an
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
We examined the discomfort level in 798 children enrolled in the Randomized Intervention for children with Vesicoureteral Reflux (RIVUR) and Careful Urinary Tract Infection Evaluation (CUTIE) studies by asking parents to rate their child’s discomfort level with each procedure on a scale from 0 to 10. We compared discomfort during the DMSA scan and the DMSA image quality between centers in which sedation was used>90% of the time (sedation centers), centers in which sedation was used
Source: Pediatric Radiology - Category: Radiology Source Type: research
Abstract AimTo determine the nature of primary vesicoureteral reflux (VUR) and the association of VUR with hydronephrosis and renal damage. MethodsThe medical records of children ≤ 15 years diagnosed with VUR, attending the Department of Pediatrics, Prince of Songkla University, Thailand between 1987 and 2013 were reviewed. Renal ultrasound and technetium‐99m dimercaptosuccinic acid renal scan (DMSA) results were examined to determine the severity of hydronephrosis and renal damage, respectively. ResultsThere were 177 boys and 211 girls. 350 (90.2%) were diagnosed following urinary tract infection (UTI). The median (I...
Source: Nephrology - Category: Urology & Nephrology Authors: Tags: Original Article Source Type: research
Conclusions— The negative predictive values indicate that normal renal sonographic and DMSA findings can predict the absence of high-grade VUR. We propose that renal sonographic findings of wall thickening as well as dilatation of the renal collecting system should be considered predictive of high-grade VUR.
Source: Journal of Ultrasound in Medicine - Category: Radiology Authors: Tags: Original Research Source Type: research
Urinary tract infection (UTI) is a common cause of bacterial infection in febrile children. Because of urological structural anomalies that are associated with UTI, imaging studies such as renal and bladder ultrasound (RBUS), voiding cystourethrography (VCUG), and 99mtechnetium-dimercaptosuccinic acid renal scan (DMSA) may be performed to evaluate acute pyelonephritis or acute lobar nephronia, obstructive uropathies, vesicoureteral reflux (VUR), and possible renal scar formation. The pathogenesis of renal scar formation remains unknown; however, VUR has an important role in renal scar formation, which may lead permanent re...
Source: Pediatrics and Neonatology - Category: Perinatology & Neonatology Authors: Tags: Editorial Source Type: research
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