Physical factors in medical rehabilitation of children with obstructive megaureter
- Authors: Novikova E.V.1,2, Razumov A.N.1,2
-
Affiliations:
- Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of Moscow Healthcare Department
- The First Sechenov Moscow State Medical University
- Issue: Vol 23, No 2 (2024)
- Pages: 111-119
- Section: Original studies
- Published: 03.12.2024
- URL: https://rjpbr.com/1681-3456/article/view/633136
- DOI: https://doi.org/10.17816/rjpbr633136
- ID: 633136
Cite item
Abstract
BACKGROUND: Obstructive megaureter in children, most commonly classified as a congenital defect of the urinary tract, is a leading cause of chronic kidney disease. Obstructive megaureter is mainly diagnosed by prenatal ultrasound of the defect. Treatment options for children with obstructive uropathy include medical and surgical interventions, but in most cases surgical treatment does not restore renal function, renal blood flow, or urodynamics. However, there is no medical rehabilitation system for these patients.
AIM: The aim of the study is to provide a scientific basis for the combined use of dry carbon dioxide baths and calcium/iodine ion electrophoresis as part of the medical rehabilitation for children with obstructive megaureter.
MATERIALS AND METHODS: Clinical observations and special studies were dynamically performed in 80 children with obstructive megaureter aged 3 to 10 years. All children received medical rehabilitation during treatment with uroseptic agents. Among them, 40 patients in the experimental group received dry carbon dioxide baths and calcium/iodine ion electrophoresis, and 40 patients in the control group received rehabilitation without physical treatment.
RESULTS: The addition of dry carbon dioxide baths and calcium/iodine ion electrophoresis in the medical rehabilitation of children with obstructive uropathy improved symptoms of intoxication and impaired urination. Positive effects of physical factors on renal function and renal blood flow are reflected in the increased glomerular filtration rate and urine osmolarity, decreased blood levels of creatinine and urea, improved renal blood flow, and growth of renal parenchyma.
CONCLUSION: Dry carbon dioxide bath activates renal circulation and metabolic processes in the renal parenchyma. Calcium/iodine ion electrophoresis has an antisclerotic and tonic effect on the smooth muscles of the renal pelvis and ureters. The combined use of these treatment options is a pathogenetically based and promising method of rehabilitation of children with obstructive uropathy.
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About the authors
Elena V. Novikova
Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of Moscow Healthcare Department; The First Sechenov Moscow State Medical University
Author for correspondence.
Email: minkamal@mail.ru
ORCID iD: 0000-0002-8987-1296
SPIN-code: 7001-7993
MD, Cand. Sci. (Medicine), Associate Professor
Russian Federation, Moscow; MoscowAleksandr N. Razumov
Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports Medicine of Moscow Healthcare Department; The First Sechenov Moscow State Medical University
Email: a-razumov@mail.ru
ORCID iD: 0000-0001-8549-0106
SPIN-code: 8793-5173
MD, Dr. Sci. (Medicine), academician of the Russian Academy of Sciences
Russian Federation, Moscow; MoscowReferences
- Aringazina AM, Narmanova OZ, Nuskabaeva GO, et al. Chronic kidney disease: Prevalence and risk factors (literature review). Health Risk Analysis. 2020;(2):164–174. EDN: OWGTJO doi: 10.21668/health.risk/2020.2.18
- Akhmedshin RZ. Predictors of progression of chronic kidney disease in children with malformations of urinary system. Exp Clin Urol. 2017;(1):126–130. EDN: ZEHPIP
- Menovshchikova LB, Rudin YE, Garmanova TN, Shaderkina VA. Clinical guidelines for pediatric urology-andrology. Moscow: Pero Publishing House; 2015. 240 p. (In Russ.)
- Smailova AS, Akashova DG, Malgeldina PN. Features of chronic kidney disease at children with obstructive uropathy. Voprosy ustoichivogo razvitiya obshchestva. 2020;3(1):411–417. EDN: BDOQVU doi: 10.34755/IROK.2020.74.86.033
- Stolova EN, Imelbaev AI. The role of ultrasonography in diagnostics of obstructive uropathy in children. Visual Med. 2020;2(2):26–33. EDN: YXVVKM
- Makovetskaya GA, Mazur LI, Balashova EA, Terekhin SS. Congenital obstructive uropathy in children: Nephroprotective strategy. Pediatriya. Zhurnal im. G.N. Speranskogo. 2017;(5):38–43. EDN: ZKAURH doi: 10.24110/0031-403X-2017-96-5-38-43
- Braga L, McGrath M, Farrokhyar F, et al. Associations of initial society for fetal urology grades and urinary tract dilatation risk groups with clinical outcomes in patients with isolated prenatal. J Urol. 2017;197(3, Pt 2):831–837. doi: 10.1016/j.juro.2016.08.099
- Babu R, Vittalraj P, Sundaram S, et al. Comparison of different pathological markers in predicting pyeloplasty outcomes in children. J Pediatr Surg. 2019;55(8):1616–1620. doi: 10.1016/j.jpedsurg.2019.08.015
- Yatsyk SP, Shamov VK, Sharkov SM. The experience of physiotherapy treatment of vesico-dependent forms megaureter in children. Pediatric Pharmacol. 2012;(1):109–111. EDN: OXKAHP
- Physical and rehabilitation medicine. National leadership. Ed. by G.N. Ponomarenko. Moscow: GEOTAR-Media; 2016. 688 p. Series "National Guides". (In Russ.)
- Pogonchenkova IV, Khan MA, Novikova EV, Menovshchikova LB. Мedical rehabilitation after surgical treatment of hydronephrosis in children. Bulletin Rehabilitat Med = Vestnik vosstanovitelʹnoj mediciny. 2019;(5):30–34. EDN: KIOPLW
- Khan MA, Razumov AN, Korchazhkina NB, Pogonchenkova IV. Physical and rehabilitation medicine in pediatrics. Moscow: GEOTAR-Media; 2018. 402 p. (In Russ.)
- Khan MA, Pogonchenkova IV, Novikova EV, Menovshchikova LB. Phasing rehabilitation of children with obstructive uropathy. Bulletin Rehabilitat Med = Vestnik vosstanovitelʹnoj mediciny. 2017;(6):81–85. EDN: ZVGCLT
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