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Gu SL, Yang XQ, Zhai YH, Xu WL, Guo WX, Shen T. Clinical characteristics of patients with prenatal hydronephrosis in early postnatal period: a single center retrospective study. BMC Pediatr 2023; 23:235. [PMID: 37173710 PMCID: PMC10176811 DOI: 10.1186/s12887-023-04063-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 05/09/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The study aims to investigate the clinical characteristics of early postnatal period in children with prenatal hydronephrosis (HN) in our single center for 8 years. STUDY DESIGN The clinical data of 1137 children with prenatal HN from 2012 to 2020 were retrospectively analyzed in our center. Variables of our study mainly included different malformations and urinary tract dilation (UTD) classification, and main outcomes were recurrent hospitalization, urinary tract infection (UTI), jaundice, and surgery. RESULTS Among the 1137 children with prenatal HN in our center, 188 cases (16.5%) were followed-up in early postnatal period, and 110 cases (58.5%) were found malformations. The incidence of recurrent hospitalization (29.8%) and UTI (72.5%) were higher in malformation, but the incidence of jaundice (46.2%) was higher in non-malformation(P < 0.001). Furthermore, UTI and jaundice were higher in vesicoureteral reflux (VUR) than those in uretero-pelvic junction obstruction (UPJO) (P < 0.05). Meanwhile, Children with UTD P2 and UTD P3 were prone to recurrent UTI, but UTD P0 was prone to jaundice (P < 0.001). In addition, 30 cases (16.0%) of surgery were all with malformations, and the surgical rates of UTD P2 and UTD P3 were higher than those of UTD P0 and UTD P1 (P < 0.001). Lastly, we concluded that the first follow-up should be less than 7 days, the first assessment should be 2 months, and the follow up should be at least once every 3 months. CONCLUSION Children with prenatal HN have been found many malformations in early postnatal period, and with high-grade UTD were more prone to recurrent UTI, even to surgery. So, prenatal HN with malformations and high-grade UTD should be followed up in early postnatal period regularly.
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Affiliation(s)
- Song-Lei Gu
- Department of Pediatrics, Women and Children's Hospital of Xiamen University, School of Medicine, Xiamen University, Zhenhai road 10, Xiamen, 361003, China
| | - Xiao-Qing Yang
- Department of Pediatrics, Women and Children's Hospital of Xiamen University, School of Medicine, Xiamen University, Zhenhai road 10, Xiamen, 361003, China
| | - Yi-Hui Zhai
- Department of Nephrology, Children's Hospital of Fudan University, Wanyuan road 399, Shanghai, 201102, China
| | - Wen-Li Xu
- Department of Pediatrics, Women and Children's Hospital of Xiamen University, School of Medicine, Xiamen University, Zhenhai road 10, Xiamen, 361003, China
| | - Wen-Xing Guo
- Department of Pediatrics, Women and Children's Hospital of Xiamen University, School of Medicine, Xiamen University, Zhenhai road 10, Xiamen, 361003, China
| | - Tong Shen
- Department of Pediatrics, Women and Children's Hospital of Xiamen University, School of Medicine, Xiamen University, Zhenhai road 10, Xiamen, 361003, China.
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Yu MH, Miao L, Zhai YH, Chen J, Fang XY, Miao QF, Liu JL, Liu JJ, Tang XS, Zhang ZQ, Zhang L, Zeng L, Xu H, Shen Q. [Clinical and prognosis analysis of children with kidney retransplantation]. Zhonghua Er Ke Za Zhi 2021; 59:737-742. [PMID: 34645213 DOI: 10.3760/cma.j.cn112140-20210515-00428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analyze the clinical and prognosis of children with kidney retransplantation. Methods: Clinical data of 11 children who underwent kidney retransplantation from January 2011 to December 2020 in Department of Nephrology, Children's Hospital of Fudan University were retrospectilely analyzed. The clinical data including demographic parameters, primary diagnosis, characteristics in the follow-up of renal allograft were analyzed. Results: Totally 11 cases received secondary renal transplantation (male 6, female 5). They were initially diagnosed with chronic kidney disease at the age of 11.9 (7.4, 13.3) years. The median duration of dialysis was 22.1 (3.5, 36.5) months. In the first transplantation, recipient age was 13.9 (11.1, 15.2) years. Ten cases received donation from cardiac death donor (DCD) (9 cases received donors aged less than one year, 5 of them received whole kidney transplantation and one case received donor aged one to three years) and 1 case with living-related donor. Ten graft failures occurred within 1 month after renal transplantation and the other one occurred at the fifth month after transplantation. The causes included vascular factors (9 cases), rejection (1 case) and primary non-function (1 case). In the second transplantation, recipient age was 14.7 (11.7, 16.2) years. All the 11 children received dialysis (7 with PD and 4 with HD) and successfully completed the second transplantation. The median time between the two transplants was 210 (16, 1 041) days. Donors were all DCD donors from 3 years of age or older. The mean follow-up duration was (42±15) months. The estimated glomerular filtration rate was (85±34)ml/(min·1.73 m2) when the last investigation after kidney retransplantation with the kidney and patient all survived. Conclusions: Kidney retransplantation may have better prognosis in children. Dialysis transition during waiting period and DCD donor from 3 years of age or older can effectively ensure the success of kidney retransplantation.
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Affiliation(s)
- M H Yu
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - L Miao
- Department of Pediatrics, the Affiliated Hospital of Kangda College of Nanjing Medical University, the First People's Hospital of Lianyungang, Lianyungang 222061, China
| | - Y H Zhai
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - J Chen
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - X Y Fang
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Q F Miao
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - J L Liu
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - J J Liu
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - X S Tang
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Z Q Zhang
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - L Zhang
- Department of Organ Transplantation, Affiliated Changhai Hospital, Navy Military Medical University, Shanghai 200433, China
| | - L Zeng
- Department of Organ Transplantation, Affiliated Changhai Hospital, Navy Military Medical University, Shanghai 200433, China
| | - H Xu
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
| | - Q Shen
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China
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Liu JL, Shen Q, Wu MY, Zhu GH, Li YF, Wang XW, Tang XS, Bi YL, Gong YN, Chen J, Fang XY, Zhai YH, Wu BB, Li GM, Sun YB, Gao XJ, Liu CH, Jiang XY, Hao S, Kang YL, Gong YL, Rong LP, Li D, Wang S, Ma D, Rao J, Xu H. Responsible genes in children with primary vesicoureteral reflux: findings from the Chinese Children Genetic Kidney Disease Database. World J Pediatr 2021; 17:409-418. [PMID: 34059960 DOI: 10.1007/s12519-021-00428-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 03/31/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Primary vesicoureteral reflux (VUR) is a common congenital anomaly of the kidney and urinary tract (CAKUT) in childhood. The present study identified the possible genetic contributions to primary VUR in children. METHODS Patients with primary VUR were enrolled and analysed based on a national multi-center registration network (Chinese Children Genetic Kidney Disease Database, CCGKDD) that covered 23 different provinces/regions in China from 2014 to 2019. Genetic causes were sought using whole-exome sequencing (WES) or targeted-exome sequencing. RESULTS A total of 379 unrelated patients (male: female 219:160) with primary VUR were recruited. Sixty-four (16.9%) children had extrarenal manifestations, and 165 (43.5%) patients showed the coexistence of other CAKUT phenotypes. Eighty-eight patient (23.2%) exhibited impaired renal function at their last visit, and 18 of them (20.5%) developed ESRD at the median age of 7.0 (IQR 0.9-11.4) years. A monogenic cause was identified in 28 patients (7.39%). These genes included PAX2 (n = 4), TNXB (n = 3), GATA3 (n = 3), SLIT2 (n = 3), ROBO2 (n = 2), TBX18 (n = 2), and the other 11 genes (one gene for each patient). There was a significant difference in the rate of gene mutations between patients with or without extrarenal complications (14.1% vs. 6%, P = 0.035). The frequency of genetic abnormality was not statistically significant based on the coexistence of another CAKUT (9.6% vs. 5.6%, P = 0.139, Chi-square test) and the grade of reflux (9.4% vs. 6.7%, P = 0.429). Kaplan-Meier survival curve showed that the presence of genetic mutations did affect renal survival (Log-rank test, P = 0.01). PAX2 mutation carriers (HR 5.1, 95% CI 1.3-20.0; P = 0.02) and TNXB mutation carriers (HR 20.3, 95% CI 2.4-168.7; P = 0.01) were associated with increased risk of progression to ESRD. CONCLUSIONS PAX2, TNXB, GATA3 and SLIT2 were the main underlying monogenic causes and accounted for up to 46.4% of monogenic VUR. Extrarenal complications and renal function were significantly related to the findings of genetic factors in children with primary VUR. Like other types of CAKUT, several genes may be responsible for isolated VUR.
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Affiliation(s)
- Jia-Lu Liu
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China.,Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Qian Shen
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China.,Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Ming-Yan Wu
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China.,Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Guang-Hua Zhu
- Department of Nephrology, Shanghai Children's Hospital, Shanghai, China
| | - Yu-Feng Li
- Department of Pediatric Nephrology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Wen Wang
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Shan Tang
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China.,Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Yun-Li Bi
- Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China.,Department of Urology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Yi-Nv Gong
- Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China.,Department of Rheumatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China.,Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Xiao-Yan Fang
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China.,Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Yi-Hui Zhai
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China.,Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Bing-Bing Wu
- Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China.,Clinical Genetic Center, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Guo-Min Li
- Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China.,Clinical Genetic Center, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Yu-Bo Sun
- Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China.,Department of Urology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Xiao-Jie Gao
- Department of Nephrology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Cui-Hua Liu
- Department of Nephrology and Rheumatology, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Key Laboratory of Pediatric Kidney Disease Research, Zhengzhou, China
| | - Xiao-Yun Jiang
- The First Affiliated Hospital of Zhongshan University, Guangzhou, China
| | - Sheng Hao
- Department of Nephrology, Shanghai Children's Hospital, Shanghai, China
| | - Yu-Lin Kang
- Department of Nephrology, Shanghai Children's Hospital, Shanghai, China
| | - Ying-Liang Gong
- Department of Pediatric Nephrology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li-Ping Rong
- The First Affiliated Hospital of Zhongshan University, Guangzhou, China
| | - Di Li
- Department of Nephrology and Rheumatology, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Key Laboratory of Pediatric Kidney Disease Research, Zhengzhou, China
| | - Si Wang
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Duan Ma
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Institutes of Biomedical Sciences, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Jia Rao
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China.,Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Hong Xu
- Department of Nephrology, Children's Hospital of Fudan University, National Children's Medical Center, 399 Wan Yuan Road, Shanghai, 201102, People's Republic of China. .,Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China.
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Yan Y, Li L, Zhai YH, Wang F. [Analysis on the status quo and influencing factors of career management of operating room nurses]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021; 39:211-214. [PMID: 33781039 DOI: 10.3760/cma.j.cn121094-20200204-00043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the status quo of operating room nurse career management in Shandong Province, and to analysis its influencing factors. Methods: In February 2019, 1418 operating room nurses in Shandong province were selected to investigate their general situation and current status of career management and analyze possible influencing factors by using the General Information Questionnaire, the Career Management Questionnaire for Nurses and the Career Planning Questionnaire for Nurses. Results: The total score of organizational career management scale was (48.24±11.12) points, with the score of dimension from high to low as valueing training (12.64±2.54) points, justice in promotion (12.11±3.04) points, providing career information (12.10±3.21) points, promotion in career self-development (11.39±3.46) points. The total score of organizational career planning scale was (43.33±9.00) points. Multiple liner regression analysis showed that career planning (β=0.742, P<0.001) , hospital grade (β=-0.068, P<0.001) and age (β=-0.065, P<0.001) were influencing factors of operating room nurse career management which could explained 57.1% of the variation (F=630.596, P<0.001) . Conclusion: Career management of operating room nurse is at a medium level, the scores of different dimensions are not balanced.Career planning score, hospital level, age and other factors affect the career management score of operating room nurses.
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Affiliation(s)
- Y Yan
- Operating Room, Qilu Hospital, Shandong University, Jinan 250012, China
| | - L Li
- Operating Room, Qilu Hospital, Shandong University, Jinan 250012, China
| | - Y H Zhai
- Operating Room, Qilu Hospital, Shandong University, Jinan 250012, China
| | - F Wang
- Operating Room, Qilu Hospital, Shandong University, Jinan 250012, China
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Zhao R, Zhou Q, Wang XW, Liu CH, Wang M, Yang Q, Zhai YH, Zhu DQ, Chen J, Fang XY, Tang XS, Zhang H, Shen Q, Xu H. COVID-19 Outbreak and Management Approach for Families with Children on Long-Term Kidney Replacement Therapy. Clin J Am Soc Nephrol 2020; 15:1259-1266. [PMID: 32665227 PMCID: PMC7480563 DOI: 10.2215/cjn.03630320] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 06/25/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES During the coronavirus disease 2019 outbreak, the treatment of families with children on long-term KRT is challenging. This study was conducted to identify the current difficulties, worries regarding the next 2 months, and mental distress experienced by families with children on long-term KRT during the coronavirus disease 2019 outbreak and to deliver possible management approaches to ensure uninterrupted treatment for children on long-term KRT. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A multicenter online survey was conducted between February 10 and 15, 2020, among the families with children on long-term KRT from five major pediatric dialysis centers in mainland China. The primary caregivers of children currently on long-term KRT were eligible and included. Demographic information, severe acute respiratory syndrome coronavirus 2 infection status, current difficulties, and worries regarding the next 2 months were surveyed using a self-developed questionnaire. The Patient Health Questionnaire-9 and the General Anxiety Disorder Scale-7 were used to screen for depressive symptoms and anxiety, respectively. RESULTS Among the children in the 220 families included in data analysis, 113 (51%) children were on dialysis, and the other 107 (49%) had kidney transplants. No families reported confirmed or suspected cases of coronavirus disease 2019. Overall, 135 (61%) and 173 (79%) caregivers reported having difficulties now and having worries regarding the next 2 months, respectively. Dialysis supply shortage (dialysis group) and hard to have blood tests (kidney transplantation group) were most commonly reported. A total of 29 (13%) caregivers had depressive symptoms, and 24 (11%) had anxiety. After the survey, we offered online and offline interventions to address their problems. At the time of the submission of this paper, no treatment interruption had been reported. CONCLUSIONS The coronavirus disease 2019 outbreak has had physical, mental, logistical, and financial effects on families with children on long-term KRT.
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Affiliation(s)
- Rui Zhao
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Qing Zhou
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Xiao-Wen Wang
- Department of Nephrology, Wuhan Children's Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cui-Hua Liu
- Department of Nephrology and Rheumatology, Affiliated Children's Hospital of Zhengzhou University, Zhengzhou, China
| | - Mo Wang
- Department of Nephrology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Qing Yang
- Department of Nephrology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yi-Hui Zhai
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Da-Qian Zhu
- Department of Psychology, Children's Hospital of Fudan University, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Xiao-Yan Fang
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Xiao-Shan Tang
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Hui Zhang
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Qian Shen
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
| | - Hong Xu
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, China
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Shen Q, Fang X, Zhai Y, Rao J, Chen J, Miao Q, Gong Y, Yu M, Zhou Q, Xu H. Risk factors for loss of residual renal function in children with end-stage renal disease undergoing automatic peritoneal dialysis. Perit Dial Int 2020; 40:368-376. [PMID: 32063214 DOI: 10.1177/0896860819893818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study analysed children with end-stage renal disease treated with automated peritoneal dialysis (APD) in our centre to explore the risk factors associated with residual renal function (RRF) loss. METHODS Children treated with APD as the initial renal replacement therapy regimen from January 2008 to December 2016 were included. All the children had a daily urine volume of ≥100 ml/m2 when APD was initiated and a dialysis follow-up time of ≥12 months. A daily urine volume of <100 ml/m2 after 12 months of APD treatment was defined as loss of RRF. Possible risk factors that may be associated with RRF loss were analysed. RESULTS A total of 66 children were included in the study. After 12 months of APD treatment, the daily urine volume decreased by 377.45 ± 348.80 ml/m2, the residual glomerular filtration rate decreased by 6.39 ± 3.69 ml/min/1.73 m2 and 29 of the patients (43.9%) developed RRF loss. The higher risk of RRF loss after 1 year of APD treatment was most pronounced in patients with daily urine volume of ≤400 ml/m2 before treatment, higher glucose exposure and higher ultrafiltration volume, while the lower risk of RRF loss was in patients with administration of diuretics. Each increase of 1 g/m2/day glucose exposure was associated with a 5% increase in RRF loss (odds ratio (OR) 1.05, p = 0.023) and each increase of 1 ml/m2/day ultrafiltration volume was associated with a 1% increase in RRF loss (OR 1.01, p = 0.013). CONCLUSION In children undergoing APD, the risk for loss of RRF is associated with low urine volume at the start of APD, high glucose loading and high peritoneal ultrafiltration volume, while preservation of RRF is associated with the usage of diuretics.
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Affiliation(s)
- Qian Shen
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - XiaoYan Fang
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - YiHui Zhai
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Jia Rao
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Jing Chen
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - QianFan Miao
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - YiNv Gong
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - MingHui Yu
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Qing Zhou
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
| | - Hong Xu
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai Kidney Development and Pediatric Kidney Disease Research Center, Shanghai, China
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Zhang XB, Gui YH, Xu X, Zhu DQ, Zhai YH, Ge XL, Xu H. Response to children's physical and mental needs during the COVID-19 outbreak. World J Pediatr 2020; 16:278-279. [PMID: 32451936 PMCID: PMC7246957 DOI: 10.1007/s12519-020-00365-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/16/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Xiao-Bo Zhang
- grid.411333.70000 0004 0407 2968Department of Respiratory Medicine, Children’s Hospital of Fudan University, Shanghai, 201102 China
| | - Yong-Hao Gui
- grid.8547.e0000 0001 0125 2443Shanghai Medical College, Fudan University, Shanghai, 201102 China
| | - Xiu Xu
- grid.411333.70000 0004 0407 2968Department of Child Health Care, Children’s Hospital of Fudan University, Shanghai, 201102 China
| | - Da-Qian Zhu
- grid.411333.70000 0004 0407 2968Department of Psychology, Children’s Hospital of Fudan University, Shanghai, 201102 China
| | - Yi-Hui Zhai
- grid.411333.70000 0004 0407 2968Department of Nephrology, Children’s Hospital of Fudan University, Shanghai, 201102 China ,grid.411333.70000 0004 0407 2968Department of Statistics and Data Management, Children’s Hospital of Fudan University, Shanghai, 201102 China
| | - Xiao-Ling Ge
- grid.411333.70000 0004 0407 2968Department of Statistics and Data Management, Children’s Hospital of Fudan University, Shanghai, 201102 China
| | - Hong Xu
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, 201102, China.
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Zhai YH, Chen Q, Han HD, Zhao XX, Gao YQ, Zhou X, He J. [Introduction of joint model and its applications in medical research]. Zhonghua Liu Xing Bing Xue Za Zhi 2019; 40:1456-1460. [PMID: 31838821 DOI: 10.3760/cma.j.issn.0254-6450.2019.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In medical follow-up studies, longitudinal data and survival data are often accompanied and associated with each other, thus respective analysis of longitudinal and survival data might lead to biased results. Joint model can correct deviations, improve the efficiency of parameter estimation and provide effective inferences by simultaneously processing longitudinal and survival data. It is a popular method in medical research. Joint model has made much progress, whereas the literature about the joint model and its application is limited in China. This paper summarizes the main idea, basic framework, parameter estimation methods of random effect joint model and introduces the analysis on AIDS data set based on the R software package 'JM' to clarify the advantages of the joint model in processing medical follow-up data and promote the use of the joint model in clinical research.
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Affiliation(s)
- Y H Zhai
- Tongji University School of Medicine, Shanghai 200092, China
| | - Q Chen
- Department of Health Statistics, The Second Military Medical University, Shanghai 200433, China
| | - H D Han
- Department of Health Statistics, The Second Military Medical University, Shanghai 200433, China
| | - X X Zhao
- Tongji University School of Medicine, Shanghai 200092, China
| | - Y Q Gao
- Tongji University School of Medicine, Shanghai 200092, China
| | - X Zhou
- Department of Health Management, Anhui Medical Universite, Hefei 230032, China
| | - J He
- Tongji University School of Medicine, Shanghai 200092, China; Department of Health Statistics, The Second Military Medical University, Shanghai 200433, China
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Li GM, Cao Q, Shen Q, Sun L, Zhai YH, Liu HM, An Y, Xu H. Gene mutation analysis in 12 Chinese children with congenital nephrotic syndrome. BMC Nephrol 2018; 19:382. [PMID: 30594156 PMCID: PMC6311020 DOI: 10.1186/s12882-018-1184-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 12/11/2018] [Indexed: 11/13/2022] Open
Abstract
Background Congenital nephrotic syndrome (CNS) is characterised by increased proteinuria, hypoproteinemia, and edema beginning in the first 3 months of life. Recently, molecular genetic studies have identified several genes involved in the pathogenesis of CNS. A systematic investigation of the genes for CNS in China has never been performed; therefore, we conducted a mutational analysis in 12 children with CNS,with the children coming from 10 provinces and autonomous regions in China. Methods Twelve children with CNS were enrolled from 2009 to 2016. A mutational analysis was performed in six children by Sanger sequencing in eight genes (NPHS1, NPHS2, PLCE1, WT1, LAMB2, LMXIB, COQ6 and COQ2) before 2014, and whole-exome sequencing was used from 2014 to 2016 in another six children. Significant variants that were detected by next generation sequencing were confirmed by conventional Sanger sequencing in the patients’ families. Results Of the 12 children, eight patients had a compound heterozygous NPHS1 mutation, one patient had a de novo mutation in the WT1 gene, and another patient with extrarenal symptoms had a homozygous mutation in the COQ6 gene. No mutations were detected in genes NPHS2, PLCE1, LAMB2, LMXIB, and COQ2 in the 12 patients. Conclusions This study demonstrates that the majority of CNS cases (67%, 8/12 patients) are caused by genetic defects, and the NPHS1 mutation is the most common cause of CNS in Chinese patients. A mutational analysis of NPHS1 should be recommended in Chinese patients with CNS in all exons of NPHS1 and in the intron-exon boundaries.
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Affiliation(s)
- Guo-Min Li
- Children's Hospital of Fudan University, 399 Wanyuanlu, Shanghai, 201102, China
| | - Qi Cao
- Children's Hospital of Fudan University, 399 Wanyuanlu, Shanghai, 201102, China
| | - Qian Shen
- Children's Hospital of Fudan University, 399 Wanyuanlu, Shanghai, 201102, China
| | - Li Sun
- Children's Hospital of Fudan University, 399 Wanyuanlu, Shanghai, 201102, China
| | - Yi-Hui Zhai
- Children's Hospital of Fudan University, 399 Wanyuanlu, Shanghai, 201102, China
| | - Hai-Mei Liu
- Children's Hospital of Fudan University, 399 Wanyuanlu, Shanghai, 201102, China
| | - Yu An
- Institutes of Biomedical Sciences of Fudan University, 220 Handanlu, Shanghai, 200433, China
| | - Hong Xu
- Children's Hospital of Fudan University, 399 Wanyuanlu, Shanghai, 201102, China.
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Cao Q, Li GM, Xu H, Shen Q, Sun L, Fang XY, Liu HM, Guo W, Zhai YH, Wu BB. [Coenzyme Q(10) treatment for one child with COQ6 gene mutation induced nephrotic syndrome and literature review]. Zhonghua Er Ke Za Zhi 2017; 55:135-138. [PMID: 28173653 DOI: 10.3760/cma.j.issn.0578-1310.2017.02.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To summarize the clinical manifestation and molecular characteristics of COQ6 mutation induced nephrotic syndrome, and to evaluate efficacy of CoQ(10) therapy. Method: Clinical data of the case with infantile nephrotic syndrome was summarized, including clinical manifestations, laboratory findings and family investigation. The patient received CoQ(10) 30 mg/(kg·d) therapy. Urine protein/creatinine ratio, serum albumin and creatinine were detected to assess the efficacy of the therapy. Result: (1) The 10 months old boy was presented with nephrotic level proteinuria and hypoalbuminemia. Extra-renal manifestations included cardiovascular abnormality, motor and mental retardation and unilateral ptosis. The patient had no consanguinity. A novel homozygous p. R360W mutation in COQ6 gene was identified and confirmed by next-generation sequencing and Sanger sequencing, respectively. Family analysis showed that homozygous p. R360W mutation in COQ6 gene was inherited from his parents. Missense p. R360W mutation was damaging by prediction online PolyPhen and SIFT software. After 2 months of CoQ(10) complementary therapy, the patient's urine protein/creatinine ratio declined from 7.2 to 1.3, and decreased further to 0.01 mg/mg with normal albumin level and renal function within 3 months. Nephropathy remission was maintained and growth retardation improved significantly during the last follow-up. Nevertheless, the patient manifested with sensorineural deafness at the age of 2 years. (2) There were 6 different mutations in coenzyme Q(10) biosynthesis monooxygenase 6 (COQ6) in 13 individuals from 7 families by homozygosity mapping in the whole world. Each mutation was linked to early-onset SRNS with sensorineural deafness. Renal biopsy revealed FSGS in 7 cases and DMS in 1 case. Other manifestations included ataxia, seizures, facial dysmorphism, nephrolithiasis and growth retardation. Four patients received CoQ(10) supplementation and responded to the treatment. Conclusion: Renal disease caused by recessive COQ6 gene mutation was nephrotic syndrome. The patient benefited from early CoQ(10) complement and reached nephropathy remission.
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Affiliation(s)
- Q Cao
- Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai 201102, China
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Shen Q, Xu H, Fang XY, Liu HM, Zhai YH, Zhang X, Zhu YH, Zeng L, Zhang L. [Clinical analysis of 39 cases who received transplantation of kidney from pediatric organ donors]. Zhonghua Er Ke Za Zhi 2016; 54:531-5. [PMID: 27412747 DOI: 10.3760/cma.j.issn.0578-1310.2016.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To explore the feasibility and clinical significance of pediatric renal transplantation using organ donations from pediatric patients donors. METHOD Clinical data of children who underwent renal transplantation using organ donations from pediatric patients between September 2011 and December 2014 were retrospectively analyzed, including diagnosis and treatment before transplant, transplant operation, immunosuppression, complication and prognosis. RESULT Totally 39 cases received pediatric organ donation-pediatric kidney transplantation. The median age at transplantation was 10.5 years. Before transplantation, 37 cases received chronic dialysis. The median waiting time for transplantation was 15 months. The 39 cases received kidneys from 29 donors who were aged from 9 days to 7 years (median 13 months). The median duration of follow-up after the transplantation was 19 months. At 3 month after transplantation and latest follow-up, the length of graft increased (11.3±6.4) mm and (17.5±10.8) mm, respectively. At 6 month and 12 month after transplantation, the height of the recipients increased (5.8±3.5) cm and (15.0±3.5) cm, respectively. At latest follow-up, the serum creatinine level was (80.3±31.9) μmol/L and the eGFR was (94.4±32.9) ml/(min·1.73 m(2)). The recipient survival rate was 100% and grafts survived in 34 cases; 3 cases lost graft function due to thrombosis of renal vessels and the other 2 cases due to bleeding and chronic allograft nephropathy. Donor age of less than 12 months carried higher risk of thrombosis/hemorrhagic complication (P=0.042) and graft dysfunction (P=0.017). CONCLUSION Favorable outcome can be obtained from pediatric organ donation-pediatric kidney transplantation. Patient survival rate reached 100% at one-year and three-year graft survival rate was 87%. The size of the allograft would increase and the height of the recipients would improve after transplantation.
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Affiliation(s)
- Q Shen
- Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai 201102, China
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Zhai YH, Xu H, Zhu GH, Wei MJ, Hua BC, Shen Q, Rao J, Ge J. Efficacy of urine screening at school: experience in Shanghai, China. Pediatr Nephrol 2007; 22:2073-9. [PMID: 17943322 DOI: 10.1007/s00467-007-0629-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Revised: 08/06/2007] [Accepted: 08/08/2007] [Indexed: 11/24/2022]
Abstract
To explore the prevalence of hematuria or proteinuria in school children in Shanghai and to evaluate the screening methods, we conducted urine screening in more than 40,000 school children between 2003 and 2005. Children were tested with dipsticks read manually (method A) or dipsticks read by machines (method B) combined with a sulfosalicylic acid test or microscopy. Some children were tested once, and others who had abnormal results in the first screening were tested again 2 weeks later. The prevalence of urine abnormalities in the first screening was more than 5.00% and of the second screening about 1.00%. Either method B or testing two urine samples for each child had higher specificity. As to the direct cost, that of screening twice with method A was lower than just screening once with method B. So using method A to screen twice for each child was not only convenient and economical, but also could reduce the false positive rate effectively. More than 10 months of follow-up diagnosed two cases of IgA nephropathy. Asymptomatic chronic renal diseases in school children could be detected through school urine screening. For Shanghai, China, screening twice using method A might be the best choice.
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Affiliation(s)
- Yi-Hui Zhai
- Department of Nephrology, Children's Hospital of Fudan University, Shanghai, People's Republic of China.
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