Severe neurological outcomes after very early bilateral nephrectomies in patients with autosomal recessive polycystic kidney disease (ARPKD).


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
29 09 2020
Historique:
received: 11 04 2020
accepted: 24 08 2020
entrez: 30 9 2020
pubmed: 1 10 2020
medline: 14 1 2021
Statut: epublish

Résumé

To test the association between bilateral nephrectomies in patients with autosomal recessive polycystic kidney disease (ARPKD) and long-term clinical outcome and to identify risk factors for severe outcomes, a dataset comprising 504 patients from the international registry study ARegPKD was analyzed for characteristics and complications of patients with very early (≤ 3 months; VEBNE) and early (4-15 months; EBNE) bilateral nephrectomies. Patients with very early dialysis (VED, onset ≤ 3 months) without bilateral nephrectomies and patients with total kidney volumes (TKV) comparable to VEBNE infants served as additional control groups. We identified 19 children with VEBNE, 9 with EBNE, 12 with VED and 11 in the TKV control group. VEBNE patients suffered more frequently from severe neurological complications in comparison to all control patients. Very early bilateral nephrectomies and documentation of severe hypotensive episodes were independent risk factors for severe neurological complications. Bilateral nephrectomies within the first 3 months of life are associated with a risk of severe neurological complications later in life. Our data support a very cautious indication of very early bilateral nephrectomies in ARPKD, especially in patients with residual kidney function, and emphasize the importance of avoiding severe hypotensive episodes in this at-risk cohort.

Identifiants

pubmed: 32994492
doi: 10.1038/s41598-020-71956-1
pii: 10.1038/s41598-020-71956-1
pmc: PMC7525474
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

16025

Investigateurs

Loai Akram Eid (LA)
Klaus Arbeiter (K)
Nadejda Ranguelov (N)
Laure Collard (L)
Aurélie De Mul (A)
Markus Feldkoetter (M)
Tomas Seeman (T)
Julia Thumfart (J)
Franziska Grundmann (F)
Matthias Galiano (M)
Björn Buchholz (B)
Rainer Buescher (R)
Karsten Häffner (K)
Oliver Gross (O)
Wanja Bernhardt (W)
Anke Doyon (A)
Michael Henn (M)
Jan Halbritter (J)
Ute Derichs (U)
Günter Klaus (G)
Bärbel Lange-Sperandio (B)
Barbara Uetz (B)
Marcus Benz (M)
Andrea Titieni (A)
Hagen Staude (H)
Heinz E Leichter (HE)
Neveen A Soliman (NA)
Luis Enrique Lara (LE)
Francisco de la Cerda Ojeda (F)
Jerome Harambat (J)
Bruno Ranchin (B)
Marc Fila (M)
Claire Dossier (C)
Olivia Boyer (O)
Matko Marlais (M)
Stella Stabouli (S)
Nakysa Hooman (N)
Francesca Mencarelli (F)
William Morello (W)
Germana Longo (G)
Francesco Emma (F)
Dovile Ruzgiene (D)
Anna Wasilewska (A)
Irena Balasz-Chmielewska (I)
Monika Miklaszewska (M)
Malgorzata Stanczyk (M)
Przemyslaw Sikora (P)
Mieczyslaw Litwin (M)
Aurelia Morawiec-Knysak (A)
Ana Teixeira (A)
Gordana Milosevski-Lomic (G)
Larisa Prikhodina (L)
Rina Rus (R)
Houweyda Jilani (H)
Engin Melek (E)
Ali Duzova (A)
Alper Soylu (A)
Cengiz Candan (C)
Lale Sever (L)
Alev Yilmaz (A)
Neslihan Cicek (N)
Nurver Akinci (N)
Sevgi Mir (S)
Ismail Dursun (I)
Yilmaz Tabel (Y)
Hulya Nalcacioglu (H)

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Auteurs

Kathrin Burgmaier (K)

Department of Pediatrics, Faculty of Medicine, University Hospital Cologne and University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Gema Ariceta (G)

Department of Pediatric Nephrology, University Hospital Vall d'Hebron, Barcelona, Spain.

Martin Bald (M)

Department of Pediatric Nephrology, Klinikum Stuttgart, Olga Children's Hospital, Stuttgart, Germany.

Anja Katrin Buescher (AK)

Department of Pediatrics II, University Hospital Essen, Essen, Germany.

Mathias Burgmaier (M)

Department of Internal Medicine I, University Hospital of the RWTH Aachen, Aachen, Germany.

Florian Erger (F)

Institute of Human Genetics, University Hospital of Cologne, Cologne, Germany.
Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

Michaela Gessner (M)

Department of General Pediatrics and Hematology/Oncology, Children's University Hospital Tuebingen, Tuebingen, Germany.

Ibrahim Gokce (I)

Division of Pediatric Nephrology, Research and Training Hospital, Marmara University, Istanbul, Turkey.

Jens König (J)

Department of General Pediatrics, University Hospital Muenster, Muenster, Germany.

Claudia Kowalewska (C)

The Children's Memorial Health Institute, Warsaw, Poland.

Laura Massella (L)

Division of Nephrology, Department of Pediatric Subspecialties, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Antonio Mastrangelo (A)

Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy.

Djalila Mekahli (D)

Department of Development and Regeneration, PKD Research Group, KU Leuven, Leuven, Belgium.
Department of Pediatric Nephrology, University Hospitals Leuven, Leuven, Belgium.

Lars Pape (L)

Department of Pediatrics II, University Hospital Essen, Essen, Germany.
Department of Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany.

Ludwig Patzer (L)

Children's Hospital St. Elisabeth and St. Barbara, Halle (Saale), Germany.

Alexandra Potemkina (A)

Department of Paediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria.

Gesa Schalk (G)

Department of Pediatrics, University Hospital Bonn, Bonn, Germany.

Raphael Schild (R)

University Children's Hospital, University Medical Center Hamburg Eppendorf, Hamburg, Germany.

Rukshana Shroff (R)

UCL Great Ormond Street Hospital for Children Institute of Child Health, UCL, London, UK.

Maria Szczepanska (M)

Department of Pediatrics, Faculty of Medical Sciences in Zabrze, SUM in Katowice, Katowice, Poland.

Katarzyna Taranta-Janusz (K)

Department of Paediatrics and Nephrology, Medical University of Bialystok, Bialystok, Poland.

Marcin Tkaczyk (M)

Department of Pediatrics, Immunology and Nephrology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.

Lutz Thorsten Weber (LT)

Department of Pediatrics, Faculty of Medicine, University Hospital Cologne and University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Elke Wühl (E)

Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany.

Donald Wurm (D)

Department of Pediatrics, Klinikum Saarbrücken, Saarbrücken, Germany.

Simone Wygoda (S)

Clinic for Children and Adolescents, Hospital St. Georg, Leipzig, Germany.

Ilona Zagozdzon (I)

Department of Pediatrics, Nephrology and Hypertension, Medical University of Gdansk, Gdansk, Poland.

Jörg Dötsch (J)

Department of Pediatrics, Faculty of Medicine, University Hospital Cologne and University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Jun Oh (J)

University Children's Hospital, University Medical Center Hamburg Eppendorf, Hamburg, Germany.

Franz Schaefer (F)

Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany.

Max Christoph Liebau (MC)

Department of Pediatrics, Faculty of Medicine, University Hospital Cologne and University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. max.liebau@uk-koeln.de.
Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. max.liebau@uk-koeln.de.

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