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To determine the prognostic value of response to treatment in patients with focal segmental glomerulo-sclerosis. FSGS includes 10-15% of idiopathic Nephrotic syndrome in children. Bulk of evidence supports disease relationship with immune system. Unfortunately, responses to immunosuppressive drugs are not desirable and progression to end-stage renal disease is common. We analyzed 62 out of 99 cases of biopsy proven idiopathic FSGS who were followed for at least 5-years or until renal failure occurred during study. Study design was historical cohort and patients were divided into two groups: exposed (resistant to treatment) and non-exposed (responsive to treatment). Correlation between prognosis and response to treatment was statistically evaluated. P-value (0.05 and relative risk ( 1 was considered significant. In 3 out of 25 steroid responsive patients (12%) and 22 out of 37 steroid resistant patients (59.5%), disease progressed to renal failure. Disease progressed to renal failure in 2 out of 11 cyclophosphamide responsive patients (18.1%), 17 out of 23 cyclophosphamide resistant patients (74.3%), and 8 out of 14 cyclosporine resistant patients (57.1%). 2 patients who responded to cyclosporine had normal renal function at the time of the last follow up. We concluded that favorable response to steroid and cyclophosphamide treatment is a protective factor against disease progression to end stage renal disease and resistance to these drugs imply a poor prognosis. For making any definite conclusion concerning response to cyclosporine treatment and prognosis, similar studies with a larger sample are required.

Background We prospectively evaluated whether serum cystatin C (CysC) detected acute kidney injury (AKI) earlier than basal serum creatinine (Cr). Methods In 107 pediatric patients at high risk of developing AKI, serum Cr and serum CysC were measured upon admission. Baseline estimated creatinine clearance (eCCl) was calculated using a CysC-based glomerular filtration rate (GFR) equation from a serum Cr measured at the pediatric intensive care unit (PICU) entrance. Results The median age was 10 months (interquartile range, 3-36 months). Serum Cr, serum CysC, and eCCl (mean ± standard deviation [range]) were 0.5 ± 0.18 mg/dl (0.2-1.1 mg/dl), 0.53 ± 0.78 (0.01-3.7 mg/l), and 72.55 ± 28.72 (20.6-176.2) ml/min per 1.73 [m.sup.2], respectively. The serum CysC level in patients with AKI was significantly higher than children with normal renal function (p Conclusions Our results identify that the sensitivity of serum CysC for detecting AKI is higher than that of serum Cr in a heterogeneous pediatric intensive care unit (PICU) population. Keywords Acute kidney injury * Serum cystatin C * Pediatric intensive care unit * Serum creatinine * Children, Introduction Acute kidney injury (AKI) is a common and potentially catastrophic complication among hospitalized and especially intensive care unit (ICU) patients with an ICU incidence of 11-67 % depending on [...]

We propose the application of a thermally tunable grating as a spatial light modulator. The grooves of a square-well grating are filled with a liquid whose refractive index depends on temperature. The variation of optical characteristics of such a grating with respect to temperature is investigated theoretically and also by simulation and experiment. A thin-film heater is then used as a heat source. The relation between intensity of the first order of diffraction versus power consumption of the thin-film heater is investigated. Finally, a thin-film heater with a desired pattern is placed at the surface of the grating to fabricate spatial light modulator. By applying electrical current to different elements of the thin-film heater, the fabricated device can project a desired pattern on a screen using a 4f imaging system. The restrictions of such a device are discussed and another structure is proposed and discussed by numerical calculations to increase the ability of the device. OCIS codes: 050.1950, 230.6120, 230.3990.

Introduction: Hydronephrosis, a condition that is mostly congenital, is considered as the most common type of pediatric urinary tract disorder. The aim of this study was the evaluation of the prognosis and outcomes of hydronephrosis in cases of congenital hydronephrosis.Methods: In a cross-sectional study, run in a tertiary clinic of pediatric nephrology, from 2015 to 2020, patients with fetal hydronephrosis were selected. Ultrasonography, urinalysis and kidney function tests were ordered for all patients and in the presence of hydronephrosis, repeated ultrasonography, voiding cystourethrography and dimercaptosuccinic acid scan were performed. In cases with evidence of obstruction, a diethylenetriamine pentaacetic acid scan and relative surgical procedures were performed.Results: Among 141 cases, mean age was 8 ± 1.4 years and 80.9% were male. Partial or complete obstruction in the right and left kidney was found in 16.3 and 24.8% of patients, respectively. The degree of hydronephrosis was mild in 46.1%, moderate in 39%, and severe in 9.2% of the patients. At the last follow-up period, hydronephrosis recovered in 46% of the patients, while 54% experienced persistence or exacerbation of the disease. Meanwhile, 7.1% of patients showed neurogenic bladder, 19.1% urinary tract infection and 22.7% urinary stones.Conclusion: Our study revealed that fetal hydronephrosis ends in complete recovery following birth in 46% of the cases. However, in cases experiencing persistent or exacerbating hydronephrosis, optimized treatment and/or surgical intervention are required.  DOI: 10.52547/ijkd.6516. [ABSTRACT FROM AUTHOR]

Background and Aim: Prenatal hydronephrosis is found in 1%-5% of pregnancies. Without well-timed diagnosis and treatment, it can lead to irreversible outcomes. Because little information is available on the indication of Vesicoureteral Reflux (VUR) regarding the antenatal diameter of the kidney pelvis, the current study aimed to determine the association between prenatal hydronephrosis and the VUR. Methods: This cross-sectional study was conducted from 2011 to 2016 on 200 neonates with hydronephrosis detected in fetal life ultrasounds in the third trimester of pregnancy. We assessed the prenatal and postnatal kidney ultrasonography of 400 kidneys and Voiding Cystourethrogram (VCUG). We employed the Spearman correlation coefficient for determining the association between study variables. The obtained data were analyzed using SPSS 16.0 software at a significance level of less than 0.05. Results: Of 200 infants, 71.5% were males and 28.5% were females. No significant relationship was found between the degree of antenatal hydronephrosis and the VCUG severity (r=0.098, P=0.106). Despite antenatal hydronephrosis, the degree of postnatal hydronephrosis and the VCUG severity was correlated (r= 0.255, P=0.001). Conclusion: There is no correlation between the severity of fetal hydronephrosis and VUR severity or the presence of a greater correlation between postnatal hydronephrosis and degree of VUR. Thus in cases of mild prenatal hydronephrosis, we suggest urinary tract ultrasonography three to seven days after birth and then cystography if postnatal sonography showed moderate or severe or progressive hydronephrosis. [ABSTRACT FROM AUTHOR]

Purpose: Knowing the epidemiological aspects of chronic kidney disease (CKD) in children is crucial for early recognition, identification of reversible causes, and prognosis. Here, we report the epidemiological characteristics of childhood CKD in Iran.Materials and Methods: This cross-sectional study was conducted during 1991 - 2009. The data were collected using the information in the Iranian Pediatric Registry of Chronic Kidney Disease (IPRCKD) core dataset.Results: A total of 1247 children were registered. The mean age of the children at registration was 0.69 ± 4.72 years (range, 0.25 -18 years), 7.79 ± 3.18 years for hemodialysis (HD), 4.24 ± 1.86 years for continuous ambulatory peritoneal dialysis (CAPD), and 3.4±1.95 years for the children who underwent the renal transplantation (RT) (P < .001). The mean year of follow-up was 7.19 ± 4.65 years. The mean annual incidence of CKD 2-5 stages was 3.34 per million age-related population (pmarp). The mean prevalence of CKD 2-5 stages was 21.95 (pmarp). The cumulative 1-, 5-, and 10-year patients' survival rates were 98.3%, 90.7%, and 84.8%, respectively. The etiology of the CKD included the congenital anomalies of the kidney and urinary tract (CAKUT) (40.01%), glomerulopathy (19.00%), unknown cause (18.28%), and cystic/hereditary/congenital disease (11.14%).Conclusion: The incidence and prevalence rate of pediatric CKD in Iran is relatively lower than those reported in Europe and other similar studies. CAKUT was the main cause of the CKD. Appropriate management of CAKUT including early urological intervention is required to preserve the renal function. Herein, the long-term survival rate was higher among the children with CKD than the literature. [ABSTRACT FROM AUTHOR]