<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2007-4085</journal-id>
<journal-title><![CDATA[Revista mexicana de urología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. mex. urol.]]></abbrev-journal-title>
<issn>2007-4085</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Mexicana de Urología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2007-40852022000300006</article-id>
<article-id pub-id-type="doi">10.48193/revistamexicanadeurologa.v82i3.832</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Renal outcome in patients with complex anorectal malformations]]></article-title>
<article-title xml:lang="es"><![CDATA[Evolución renal en pacientes con malformaciones anorrectales complejas]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fernández-Bautista]]></surname>
<given-names><![CDATA[Beatriz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fanjul]]></surname>
<given-names><![CDATA[María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Burgos]]></surname>
<given-names><![CDATA[Laura]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Molina]]></surname>
<given-names><![CDATA[Esther]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Gregorio Marañón  ]]></institution>
<addr-line><![CDATA[Madrid ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2022</year>
</pub-date>
<volume>82</volume>
<numero>3</numero>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2007-40852022000300006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2007-40852022000300006&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2007-40852022000300006&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Anorectal malformations (ARMs) are one of the most frequent congenital malformations in pediatric surgery. Its estimated incidence ranges between 1 in 2000 and 1 in 5000 live newborns approximately. The aim of the work is to present the associated urinary anomalies and functional renal outcomes in patients with worse prognosis anorectal malformations treated in our department.  Material and methods: A retrospective review of the patients operated at our center with complex anorectal malformations was performed, including urological abnormalities and long-term renal follow-up. Collected data included the type of urinary abnormality, classified as high or low, renal function (glomerular filtration rate and blood creatinine level), the presence of chronic kidney failure (CKD), the need for surgery to correct the urinary abnormality, the need for kidney transplantation and complications and long-term results.  Results: A total of 55 patients were included, 32 girls and 23 boys. Mean age at the time of corrective surgery for the anorectal malformation was 9 months (SD 2.18). The mean follow-up of the patients was 13 years (SD 7.01). Sixty-nine per cent of the patients presented some urological anomaly, being more frequent in the cloacal group. Renal structural abnormalities were found in 22 (40%) of 55 patients. They were identified in 11 (47%) cloacal patients, being the most frequent renal dysplasia (n=7; 32%), followed by position abnormalities in 3. Regarding the lower urinary tract anomalies, it was described in 32 (58%) patients. In the cloacal group, the incidence was 65%, being the most frequent vesicoureteral reflux (n = 14, 60%) as well as in the group of patients with a fistula to the prostatic urethra and in the group with exstrophies of the cloaca (n = 3, 42%). Regarding the rest of the lower urinary tract anomalies, the general incidence of anatomic bladder anomalies (bladder diverticulum, patent urachus) was 15%. As a pathology related to the upper urinary tract: primary obstructive megaureter 5%, ureterocele 1% and posterior urethral valves 1%.  Conclusions: Patients with complex anorectal malformations have a significant risk for renal impairment. Adequate screening, high level of suspicion, treatment and long term follow up of any associated urinary anomaly in patients with complex anorectal malformations is essential to preserve renal function and prevent CKD. Care by a multidisciplinary team and adequate transition to adulthood is essential to optimize the medical management of patients and long-term outcomes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: Las malformaciones anorrectales son una de las malformaciones congénitas más frecuentes en cirugía pediátrica. Su incidencia estimada oscila entre 1 en 2000 y 1 en 5000 recién nacidos vivos aproximadamente. El objetivo del trabajo es presentar las anomalías urinarias asociadas y los resultados renales funcionales en pacientes con malformaciones anorrectales de peor pronóstico atendidos en nuestro servicio.  Material y métodos: Se realizó una revisión retrospectiva de los pacientes intervenidos en nuestro centro con malformaciones anorrectales complejas, incluyendo alteraciones urológicas y seguimiento renal a largo plazo. Los datos recogidos incluían el tipo de anomalía urinaria, clasificada como alta o baja, la función renal (tasa de filtración glomerular y nivel de creatinina en sangre), la presencia de insuficiencia renal crónica (ERC), la necesidad de cirugía para corregir la anomalía urinaria, la necesidad de trasplante renal y complicaciones y resultados a largo plazo.  Resultados: Se incluyeron un total de 55 pacientes, 32 niñas y 23 niños. La edad media en el momento de la cirugía fue de 9 meses (DE 2,18). El seguimiento medio de los pacientes fue de 13 años (DE 7,01). El 69% de los pacientes presentó alguna anomalía urológica, siendo más frecuente en el grupo cloacal. Se encontraron anomalías estructurales renales en 22 (40%) de 55 pacientes. Se identificaron en 11 (47%) pacientes cloacales, siendo la displasia renal la más frecuente (n=7; 32%), seguida de las anomalías de posición en 3. En cuanto a las anomalías del tracto urinario inferior, se describió en 32 (58%). pacientes En el grupo cloacal la incidencia fue del 65%, siendo el reflujo vesicoureteral el más frecuente (n = 14, 60%) así como en el grupo de pacientes con fístula a la uretra prostática y en el grupo con extrofias de la cloaca ( n = 3, 42%). Respecto al resto de anomalías del tracto urinario inferior, la incidencia general de anomalías anatómicas vesicales (divertículo vesical, uraco permeable) fue del 15%. Como patología relacionada con el tracto urinario superior: megauréter obstructivo primario 5%, ureterocele 1% y válvulas de uretra posterior 1%.  Conclusiones: Los pacientes con malformaciones anorrectales complejas tienen un riesgo importante de insuficiencia renal. El cribado adecuado, alto nivel de sospecha, tratamiento y seguimiento a largo plazo de cualquier anomalía urinaria asociada en pacientes con malformaciones anorrectales complejas es fundamental para preservar la función renal y prevenir la ERC. La atención por un equipo multidisciplinario y la transición adecuada a la edad adulta son fundamentales para optimizar el manejo médico de los pacientes y los resultados a largo plazo.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Anorectal malformation]]></kwd>
<kwd lng="en"><![CDATA[urological anomalies]]></kwd>
<kwd lng="en"><![CDATA[cronic kidney disease]]></kwd>
<kwd lng="es"><![CDATA[Malformación anorrectal]]></kwd>
<kwd lng="es"><![CDATA[anomalías urológicas]]></kwd>
<kwd lng="es"><![CDATA[enfermedad renal crónica]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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