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Title Initial screening for bedwetting: the use of questionnaires and voiding diaries. First results from a National Belgian study Authors S. Karamaria2, N. Ranguelov3, P. Hansen4, V. De Boe5, P. Verleyen6, J. Vande Walle1,2, L. Dossche2, A. Bael7,8 1Department of Pediatric Nephrology, UZ Gent, Ghent, 2Ghent University, 3Department of Pediatrics, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, 4Department of Pediatrics, CHU Tivoli, La Louvière, 5Department of Urology, UZ Brussel, Brussels, 6Department of Urology, AZ Groeninge, Kortrijk, 7Department of Pediatrics, Pediatric Nephrology, ZNA Koningin Paola Kinderziekenhuis, Antwerp; 8Faculty of Medicine, University of Antwerp, Antwerp Background International guidelines have a consensus that stratification of nocturnal enuresis (NE) into non-monosymptomatic (NMNE) and monosymptomatic (MNE) is mandatory at intake to optimize therapeutic approach. This stratification is based on clinical parameters (presence or absence of Lower Urinary Tract Symptoms (LUTS) respectively). To identify clinical parameters a checklist (Clinical Management Tool (CMT)) and/or voiding diaries based on home recordings can be used. However, these recordings can be time consuming and difficult for the family. Moreover, the added value to the CMT, especially in treatment naïve patients, is rather expert opinion than evidence based. Methods The aim of this study run in 7 Belgian Hospitals, was to document in treatment naïve NE patients >5 years: 1) The prevalence of MNE vs NMNE 2) the added value and correlation of CMT and/or diary in differentiating NE. Two study visits were scheduled: At visit 1 CMT was obtained, after a thorough medical history and basic assessments. If daytime incontinence and/or LUTS were identified, the diagnosis was NMNE. After the 1st study visit, a 2day voiding diary (fluid intake, voiding volumes, incontinence) was registered at home. During the second study visit, this diary was evaluated; if the micturition frequency was >8 or 8 voidings/day) between what the parents answered on the CMT and what they registered in the diary (κ=-0,057). Conclusion NMNE is more frequent than MNE in treatment naïve patients. CMT alone versus CMT + diary had a different sensitivity and specificity of identifying LUTS : in absence of validation of the importance by a therapeutic trial outcome, we state that we can only consider patients as MNE when and CMT and diary do not demonstrate LUTS.

Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common monogenic cause of renal failure. For several decades, ADPKD was regarded as an adult-onset disease. In the past decade, it has become more widely appreciated that the disease course begins in childhood. However, evidence-based guidelines on how to manage and approach children diagnosed with or at risk of ADPKD are lacking. Also, scoring systems to stratify patients into risk categories have been established only for adults. Overall, there are insufficient data on the clinical course during childhood. We therefore initiated the global ADPedKD project to establish a large international pediatric ADPKD cohort for deep characterization., Methods: Global ADPedKD is an international multicenter observational study focusing on childhood-diagnosed ADPKD. This collaborative project is based on interoperable Web-based databases, comprising 7 regional and independent but uniformly organized chapters, namely Africa, Asia, Australia, Europe, North America, South America, and the United Kingdom. In the database, a detailed basic data questionnaire, including genetics, is used in combination with data entry from follow-up visits, to provide both retrospective and prospective longitudinal data on clinical, radiologic, and laboratory findings, as well as therapeutic interventions., Discussion: The global ADPedKD initiative aims to characterize in detail the most extensive international pediatric ADPKD cohort reported to date, providing evidence for the development of unified diagnostic, follow-up, and treatment recommendations regarding modifiable disease factors. 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