UN CAZ DE HIDRONEFROZĂ GIGANTĂ ASOCIATĂ CU HIPERTENSIUNE ARTERIALĂ

Cazurile de hidronefroză gigantă sunt rare şi, de obicei, nu conţin mai mult de 1-2 litri de lichid în sistemul colector. Prezentăm un caz de hidronefroză gigantă însoţită de hipertensiune arterială (HTA) tranzitorie secundară. Cu ocazia unui examen de rutină, unui pacient de 14 ani, supraponderal, i-au fost descoperite valori crescute ale teniunii arteriale. Istoricul medical a fost nesemnifi cativ. Ecografi a abdominală a evidenţiat o tumoră chistică gigantă ce ocupa peste 50% din cavitatea abdominală. Deşi simptomele clinice cât şi examenul fi zic au fost sărace, iar iniţial HTA părea indusă de obezitate, în cele din urmă HTA s-a dovedit a fi secundară hidronefrozei gigante. Prin urmare, diagnosticul diferenţiar al unei formaţiuni abdominale chistice, chiar şi în absenţa altor patologii evidente, ar trebui să includă o posibilă hidronefroză

Thrombosis in Chronic Kidney Disease in Children

Venous thromboembolism (VTE) in children is a rare condition. An increased incidence has been observed in the last few years due to several factors, such as increased survival in chronic conditions, especially chronic kidney disease (CKD), use of catheters, and increased sensitivity of diagnostic tools. VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE). VTE in children is associated with a two to six times higher mortality risk and a 5–10% prevalence of post-thrombotic syndrome. Overall, 5% of VTE episodes in children are associated with chronic kidney disease. The etiology of VTE in chronic kidney disease covers a wide range of pathologies. Various types of thrombotic complications may occur during long-term use of a chronic dialysis catheter. VTE occurs in 3% of children with nephrotic syndrome (NS). The risks for VTE and arterial thromboembolism (ATE) were particularly high in the first 6 months after the onset of NS. Other causes of VTE are graft rejection due to thrombosis of vascular anastomoses after kidney transplantation (3%) and autoimmune diseases (lupus nephritis, antiphospholipid syndrome). In this state-of-the-art overview, we have reviewed the physiologic and pathologic mechanisms underlying pediatric thrombosis and updated current diagnostic and treatment options, emphasizing personal experience as well