Abstract Justification and objective: Renal lithiasis is due to the precipitation of crystals due to an imbalance in the urine between promoting substances and inhibitory substances. It is a pathology with a prevalence between 2–10% in the pediatric population, with an incidence that has increased in the last 25 years; for this reason this study aims to know the prevalence, clinical and metabolic manifestations of renal lithiasis in the pediatric population of the National Children's Hospital of Costa Rica. Methods : Tthis is a retrospective, descriptive and observational study, through the review of records of patients under 18 years of age with the diagnosis of renal lithiasis, attended at the National Children's Hospital, in the period from January 2000 to 2018. Results : A total of 106 patients were included. The average age at diagnosis was 6.6 ± 3.8 years; the frequency of cases has increased 5.5 times in the last 5 years. Risk factors detected: urinary tract abnormalities 22.6% and family history of lithiasis 17.9%. Metabolic analysis showed low urine output in 74.3%, hyperphosphaturia in 43.2%, hypomagnesuria 39.2% and hypercalciuria 37.8%. Etiologies determined: metabolic 54.7%, urinary tract malformations 16% and idiopathic in 30.9%. Intracorporeal lithotripsy was applied in 61.2%. Recurrence was observed in 28.5% of cases, and a relationship was found between the incidence of recurrence and the size of the lithotripsy (p = 0.001) and surgical treatment (p = 0.010). Conclusions : There is an increase in the frequency of cases of pediatric lithiasis with a multifactorial etiology at the National Children's Hospital of Costa Rica.

Abstract Objective: To investigate the incidence of congenital anomalies of the kidney and urinary tract (CAKUT)in neonates, and to evaluate the value of urinary ultrasound screening in the early postnatal period. Methods: The neonates born or treated in Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University between January 2016 and December 2018 accepted the urinary ultrasound screening, and the neonates with problem were followed up. In the meanwhile, the maternal pregnancy data were analyzed to screen out the risk factors associated with the onset of CAKUT. Results: (1)A total of 2655 neonates were screened by ultrasonography, of whom 82 neonates had been diagnosed with CAKUT (male: 60 cases, female: 22 cases), the positive rate was 3. 1% (82 /2655). There were 66 cases of hydronephrosis, 6 cases of duplicate kidney, 2 cases of multiple renal cysts, 2 cases of renal cystic dysplasia, 1 case of medullary sponge kidney, 3 cases of small kidney, 1 case of isolated kidney, and 1 case of horseshoe kidney. (2)Of the 66 children with hydronephrosis, 4 cases were lost to the follow-up; 8 cases were followed for less than six months with no significant changes found, and still in the follow-up observation; 54 cases were followed up for 1 year, among which 32 cases were returned to normal within 1 year, 3 cases were alleviated, 7 cases were aggravated, and 12 cases were unchanged. One case underwent surgery for repeated urinary tract infections and decreased renal function. (3)Abnormal fetal urinary ultrasound in the late pregnancy was found to be the most common in the high risk factors of CAKUT. There were 44 high-risk newborns with abnormal fetal urinary ultrasound, and 35 cases of CAKUT were diagnosed after birth. The incidence rate was 795% (35 /44). (4)Among the 2655 newborns screened, 2611 newborns had normal antenatal urinary ultrasonography. Among these neonates with normal urinary ultrasound during pregnancy, 47 cases of CAKUT were diagnosed after birth, with an incidence of 18% (47 /2611). Conclusion: The most common CAKUT in neonates is hydronephrosis and most cases with hydronephrosis had a good prognosis, but they should be followed up regularly. Urinary ultrasound screening for neonates, especially those high-risk neonates with abnormal fetal urinary ultrasound, has important clinical implications for the early detection of CAKUT.

Abstract A sexual dysfunction and lower urinary tract symptoms have been a hot issue in recent years for scientists to study. There have been several clinical epidemiologic studies conducted in order to examine the connections between these two seemingly unrelated areas of urology research. In this review, an attempt is made to address these two sectors, their influence on patients’ quality of life, shared pathophysiological processes, and therapeutic features. Many urological patients suffer from both conditions, which are widespread in the general community. Phosphodiesterase type 5 inhibitors, the generally accepted combo therapy in this situation, sparked interest in finding alternative therapeutic choices.

Abstract Objective To explore the effects of alprostadil combined with levocarnitine on renal function and serum levels of toll⁃like receptor⁃4 (TLR⁃4), interleukin⁃18 (IL⁃18) and tumor necrosis factor⁃α (TNF⁃α) in patients with end ⁃ stage diabetic nephropathy (ESDN). Methods 88 cases of patients with ESDN admitted between January 2015 and January 2018 were divided into observation group ( n =44) and control group ( n =44) Alprostadil was applied to both groups, and the observation group was combined with levocarnitine. renal function [serum creatinine (SCr), urea nitrogen (BUN), glomerular filtration rate (eGFR)], inflammatory factors (TLR⁃4, IL⁃18, TNF - α) and blood biochemical indicators [hemoglobin(Hb), serum albumin(ALB), cholesterol(TC)] were evaluated before treatment and after 4 weeks of treatment. The incidence rate of dialysis adverse reactions was recorded in the 2 groups. After 4 weeks of treatment, the levels of SCr and BUN in the 2 groups were lower than those before treatment (P<0.05), and the decrease in observation group was greater than that in control group (P<0.05). There was no significant difference in the eGFR within⁃groups before and after treatment and between groups(P>0.05). After 4 weeks of treatment, the levels of TLR⁃4, IL⁃18 and TNF⁃α in the 2 groups were lower than those before treatment (P<0.05), and the decrease in observation group was greater than that in control group (P<0.05). After 4 weeks of treatment, the levels of Hb and ALB in the 2 groups were higher than those before treatment (P<0.05) while the TC level in the 2 groups was lower than that before treatment (P<0.05), and the changes in observation group were greater than those in control group ( P<0.05 ). The incidence rate of adverse reactions in observation group was lower than in control group (P<0.05 ). Conclusions Alprostadil combined with levocarnitine is beneficial to reduce the levels of inflammatory factors, protect patients' renal function, Alprostadil combined with levocarnitine is beneficial to reduce the levels of inflammatory factors, protect patients' renal function, and reduce the risk of adverse reactions.

Abstract Foundation: intrauterine growth restriction constitutes a complication of pregnancy. Newborns with this condition are exposed to an increased risk of perinatal and postnatal morbidity and mortality. Objective: to evaluate morphological markers of hypoxia in fetal and kidney development, using a model of placental insufficiency treated with human erythropoietin with low sialic acid content (neuro-Epo) in rats. Methods: three groups of gestated rats from the Wistar line were used. A control group (group I) and two experimental groups (groups II and III) with six rats each. Rats of groups II and III had uterine artery ligation on day 16 of pregnancy (E 16). Group III from E16 to E19 was administered a dose of 0.5 mg / kg / day of neuro-Epo subcutaneously and group II was administered placebo. On the 20th day of gestation the fetuses and their placentas were weighed. The fetuses' size and cephalic diameters were measured. Morphometric and histological features in the fetal kidney were studied with hematoxylin-eosin staining and PAS. A qualitative histopathological analysis of their cell types was performed. Results: fetuses with intrauterine growth restriction did not improve growth markers. Hypoxia lesions were found in the fetal kidney of the untreated IUGR group that improved by administering neuro-Epo. Conclusions: the administration of neuro-Epo only showed reparative and protective effects on histological alterations caused by hypoxia in the fetal kidney.