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The meta‐analysis aimed to assess renal function (RF) as a risk factor for diabetic foot ulcers (DFUs). Using dichotomous or contentious random or fixed effect models, the outcomes of this meta‐analysis were examined, and the odds Ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) were computed. 16 examinations from 2004 to 2023 were enrolled for the present meta‐analysis, including 808 914 individuals with diabetes mellitus (DM). DFU had significantly higher chronic renal failure (OR, 3.17; 95% CI, 1.97–5.09, p < 0.001), higher serum Creatinine (MD, 29.30; 95% CI, 9.68–48.92, p = 0.003), and a low estimated glomerular filtration rate (MD, −15.31; 95% CI, −19.36 to −11.26, p < 0.001) compared to non‐DFU patients with DM. The examined data revealed that DFU had significantly higher chronic renal failure, higher serum Creatinine, and a low estimated glomerular filtration rate compared to non‐DFU patients with DM. Yet, attention should be paid to its values since some comparisons had a low number of selected studies. [ABSTRACT FROM AUTHOR]

Background: Recommendations on when to start enzyme replacement therapy (ERT) in children with Fabry disease (FD) differ between guidelines. In this study, kidney biopsies of a cohort of 14 untreated children and one treated child were analyzed for their morphologic changes to determine whether early initiation of ERT is indicated. Methods: All pediatric FD patients (< 18 years old) diagnosed between 2003 and 2021 in our department who received a kidney biopsy were enrolled. Clinical symptoms; laboratory parameters regarding kidney function, such as eGFR, plasma urea, protein-creatinine, and albumin/creatinine ratio; and 14 kidney biopsies prior to ERT and one under treatment were retrospectively analyzed. Results: A total of 14 patients were enrolled, including 9 male and 5 female children, aged 3–18 years (median age 11). Seven of the enrolled children were 10 years old or younger. Histological analysis of kidney biopsy samples revealed severe vacuolization and accumulation of inclusions in podocytes and renal tubules. The majority of cases had no FD-specific clinical or laboratory features independent of age, gender, or genotype. The youngest FD patient presenting with isolated abnormal kidney biopsy was 3 years old. Conclusions: We demonstrate that histological lesions, typical for FD, can be observed in kidney biopsies at a very young age in patients without classical clinical symptoms or laboratory abnormalities. Thus, we recommend kidney biopsies as a possible tool for early diagnosis of renal involvement in FD. As a consequence of these early biopsy findings without a clinical correlate, an early initiation of ERT should be considered. [ABSTRACT FROM AUTHOR]

Introduction: The most common interventions in lower urinary tract obstruction are vesico-amniotic shunting (VAS) and serial amnioinfusions; however, their outcome remains uncertain. The aim of the study was to assess the kidney function as well as clinical complications in boys at the age of 6 months with posterior urethral valves (PUV), who underwent prenatal VAS and survived the neonatal period. Material and methods: The study group consisted of 14 boys and the mean time of the VAS procedure was 22 weeks of gestational age (GA). Children were born in 34 GA (29--39) with average birth weight of 2860 g. Four fetuses needed amnioinfusion. In the study we assessed physical development, prevalence and aetiology of urinary tract infections (UTIs), number of hospitalizations, estimated glomerular filtration rate, presence of hypertension, albuminuria, proteinuria and acidosis. Results: Average body weight at 6 months of life was 7.2 kg. 86% of children had at least one UTI; the same percentage were given antibacterial prophylaxis. 36% underwent urinary diversion. Median number of hospitalizations was 4. One patient required chronic renal replacement therapy, and one needed a short course of peritoneal dialysis. Median serum creatinine level was 0.65 mg/dl with estimated glomerular filtration rate (eGFR) 50.6 ml/min/1.73 m². Average serum cystatin C level was 1.50 mg/l with eGFR 48.5 ml/min/1.73 m². 43% developed acidosis. 71% had elevated albuminuria with a median urine albumin-to-creatinine ratio of 581.64 mg/g. 28.5% had overt proteinuria. Conclusions: Growth at the age of 6 month of infants with PUV after prenatal VAS was barely satisfactory. More than half had impaired kidney function, but the need for renal replacement therapy was uncommon. [ABSTRACT FROM AUTHOR]