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      Sterile leukocyturia − Difficult diagnostic problem in children Translated title: Jałowa Leukocyturia − Trudny Problem Diagnostyczny u Dzieci

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          Abstract

          Sterile leukocyturia is an important and difficult clinical problem in children. In this paper, we described the most common nephrologic causes of sterile leukocyturia, including infectious, non-infectious and extrarenal etiology. We stressed an the importance of appropriate urine collection for urinalysis. There is a need for treatment of inflammation and also for diagnosis of potential anomalies of urethral orifice as causes of sterile leukocyturia in children.

          Streszczenie

          Jałowa leukocyturia stanowi istotny i trudny problem kliniczny u dzieci. W artykule omówiono najczęstsze nerkowe przyczyny jałowej leukocyturii o podłożu infekcyjnym i nieinfekcyjnym oraz przyczyny pozanerkowe. Podkreślono znaczenie prawidłowego pobrania moczu na badanie ogólne oraz wyeliminowania stanu zapalnego i nieprawidłowości okolicy cewki moczowej jako przyczyny jałowej leukocyturii u dzieci.

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          Clinical practice. Genital herpes.

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            Nonsteroidal anti-inflammatory drugs are an important cause of acute kidney injury in children.

            To characterize nonsteroidal anti-inflammatory drug (NSAID)-associated acute kidney injury (AKI) in children.
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              Nephrotoxicity as a cause of acute kidney injury in children

              Many different drugs and agents may cause nephrotoxic acute kidney injury (AKI) in children. Predisposing factors such as age, pharmacogenetics, underlying disease, the dosage of the toxin, and concomitant medication determine and influence the severity of nephrotoxic insult. In childhood AKI, incidence, prevalence, and etiology are not well defined. Pediatric retrospective studies have reported incidences of AKI in pediatric intensive care units (PICU) of between 8% and 30%. It is widely recognized that neonates have higher rates of AKI, especially following cardiac surgery, severe asphyxia, or premature birth. The only two prospective studies in children found incidence rates of 4.5% and 2.5% of AKI in children admitted to PICU, respectively. Nephrotoxic drugs account for about 16% of all AKIs most commonly associated with AKI in older children and adolescents. Nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics, amphotericin B, antiviral agents, angiotensin-converting enzyme (ACE) inhibitors, calcineurin inhibitors, radiocontrast media, and cytostatics are the most important drugs to indicate AKI as significant risk factor in children. Direct pathophysiological mechanisms of nephrotoxicity include constriction of intrarenal vessels, acute tubular necrosis, acute interstitial nephritis, and—more infrequently—tubular obstruction. Furthermore, AKI may also be caused indirectly by rhabdomyolysis. Frequent therapeutic measures consist of avoiding dehydration and concomitant nephrotoxic medication, especially in children with preexisting impaired renal function.
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                Author and article information

                Journal
                Dev Period Med
                Dev Period Med
                jmotherandchild
                jmotherandchild
                Developmental Period Medicine
                Sciendo
                1428-345X
                2354-0060
                June 2017
                11 August 2017
                : 21
                : 2
                : 139-143
                Affiliations
                [1 ]Katedra i Klinika Pediatrii i Nefrologii, Warszawski Uniwersytet Medyczny, Polska
                Author notes
                [* ] Agnieszka Szmigielska Katedra i Klinika Pediatrii i Nefrologii, Warszawski Uniwersytet Medyczny ul. Żwirki i Wigury 63a Warsaw, Poland tel. (22) 317-96-56 fax (22) 317-99-54 agnieszka.szmigielska@ 123456wum.edu.pl
                Article
                devperiodmed.20172102.139143
                10.34763/devperiodmed.20172102.139143
                8522970
                28796985
                f594d96d-1570-48a2-be7e-fed525d8fd5b
                © 2017 Agnieszka Szmigielska, Grażyna Krzemień, published by Sciendo

                This work is licensed under the Creative Commons Attribution 4.0 International License.

                History
                : 10 April 2017
                : 24 May 2017
                Page count
                Pages: 5
                Categories
                Public Health/Zdrowie Publiczne

                leukocyturia,jałowa leukocyturia,badanie ogólne moczu,atypowe zakażenie układu moczowego,dzieci,sterile leukocyturia,urinalysis,atypical urinary tract infection,children

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