Physical factors in medical rehabilitation of children with obstructive megaureter

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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; Moscow

Aleksandr 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; Moscow

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Supplementary files

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2. Fig. 1. Symptoms of intoxication in children with obstructive megaureter. * Statistically significant differences in indicators before and after treatment in groups (p <0.05).

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3. Fig. 2. Indicators of kidney ultrasound with Doppler sonography in children with obstructive megaureter. * Statistically significant differences in indicators before and after treatment in groups (p <0,05).

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