{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T23:02:25Z","timestamp":1784674945808,"version":"3.55.0"},"reference-count":16,"publisher":"Georg Thieme Verlag KG","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Klin Padiatr"],"abstract":"Abstract<\/jats:title>\n In children with neurogenic bladder, urine cultures and uropathogen patterns\n often guide treatment decisions. Whether these patterns add to renal risk\n beyond established anatomical and urodynamic factors is unclear.<\/jats:p>\n Retrospective cohort of 151 children with neurogenic bladder followed between\n November 2023 and March 2025. Contaminated urine cultures were excluded from\n primary multivariable analyses.<\/jats:p>\n Uropathogen category (E. coli, Proteus spp., other Gram-negative organisms)\n was modelled together with high-grade vesicoureteral reflux,\n ultrasonographic megaureter, bladder wall thickness, and maximum filling\n detrusor pressure (Pdet). Renal injury was defined as advanced DMSA scarring\n (score\u22653) and reduced function (eGFR<90 mL\/min\/1.73 m\u00b2). Multivariable\n logistic regression was used.<\/jats:p>\n Megaureter independently predicted advanced scarring (OR 5.86; 95% CI\n 1.73\u201319.87; p=0.005). Higher Pdet was independently associated with reduced\n eGFR (OR 1.41 per 10 mmHg; 95% CI 1.10\u20131.82; p=0.007). Uropathogen category\n was not independently associated with renal injury.<\/jats:p>\n In pediatric neurogenic bladder, renal vulnerability is driven mainly by\n pressure and by upper tract anatomy rather than by uropathogen identity.<\/jats:p>\n The findings suggest that pressure-related factors may contribute more\n strongly to renal injury than the isolated pathogen itself. Long-term renal\n protection should prioritize storage pressure control and upper tract\n drainage.<\/jats:p>","DOI":"10.1055\/a-2907-7807","type":"journal-article","created":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T22:32:45Z","timestamp":1783290765000},"source":"Crossref","is-referenced-by-count":0,"title":["Renal Outcomes in Children with Neurogenic Bladder: Anatomical and\n Urodynamic Determinants Beyond Uropathogen Type"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7811-5949","authenticated-orcid":false,"given":"Derya","family":"Yayla","sequence":"additional","affiliation":[{"name":"Ministry of Health Izmir City Hospital, Turkey","place":["\u0130zmir"],"department":["Pediatric Urology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunes","family":"Isik","sequence":"additional","affiliation":[{"name":"Cumhuriyet University Faculty of Medicine, Turkey","place":["Sivas"],"department":["Pediatric Nephrology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.eururo.2014.11.007","article-title":"Urinary tract infections in children: EAU\/ESPU guidelines","volume":"67","author":"R Stein","year":"2015","journal-title":"Eur Urol"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1002\/nau.24211","article-title":"EAU\/ESPU guidelines on the management of neurogenic bladder in children and\n adolescent part I: Diagnostics and conservative treatment","volume":"39","author":"R Stein","year":"2020","journal-title":"Neurourol Urodyn"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1002\/nau.24248","article-title":"EAU\/ESPU guidelines on the management of neurogenic bladder in children and\n adolescent part II: Operative management","volume":"39","author":"R 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Nephrol"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"1175","DOI":"10.1111\/jpc.12938","article-title":"Renal scarring and chronic kidney disease in children with spina bifida in a\n multidisciplinary Malaysian centre","volume":"51","author":"Y Kanaheswari","year":"2015","journal-title":"J Paediatr Child Health"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/s00383-024-05696-y","article-title":"Bladder height to width ratio as a surrogate marker for non-physiological\n storage pressures in children with spinal dysraphism","volume":"40","author":"S Aithal","year":"2024","journal-title":"Pediatr Surg Int"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.ucl.2015.05.006","article-title":"Urinary tract infection and neurogenic bladder","volume":"42","author":"M J McKibben","year":"2015","journal-title":"Urol Clin North Am"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"e83","DOI":"10.1093\/cid\/ciy1121","article-title":"Clinical practice guideline for the management of asymptomatic bacteriuria: 2019\n update by the Infectious Diseases Society of America","volume":"68","author":"L E Nicolle","year":"2019","journal-title":"Clin Infect Dis"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"i939","DOI":"10.1136\/bmj.i939","article-title":"Global prevalence of antibiotic resistance in paediatric urinary tract\n infections caused by Escherichia coli and association with routine use of\n antibiotics in primary care: Systematic review and meta-analysis","volume":"352","author":"A Bryce","year":"2016","journal-title":"BMJ"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1542\/peds.2013-0557","article-title":"Variation in definitions of urinary tract infections in spina bifida patients: a\n systematic review","volume":"132","author":"R J Madden-Fuentes","year":"2013","journal-title":"Pediatrics"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"567.e1","DOI":"10.1016\/j.jpurol.2018.07.016","article-title":"Variation among subspecialists in the diagnosis of urinary tract infection in\n children with neurogenic bladders","volume":"14","author":"C S Forster","year":"2018","journal-title":"J Pediatr Urol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"S54","DOI":"10.4111\/icu.2017.58.S1.S54","article-title":"Management of vesicoureteral reflux in neurogenic bladder","volume":"58","author":"C Q Wu","year":"2017","journal-title":"Invest Clin Urol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"839.e1","DOI":"10.1016\/j.jpurol.2020.09.015","article-title":"A simple screening tool for an unfavorable bladder in children with\n myelomeningocele: Is the height to width ratio of the cystogram useful to\n predict high-pressure bladder?","volume":"16","author":"Y Kumano","year":"2020","journal-title":"J Pediatr Urol"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1002\/nau.70131","article-title":"Evaluation of bladder dysfunction outcomes among standardized bladder shapes in\n children with spina bifida","volume":"44","author":"Z S Gan","year":"2025","journal-title":"Neurourol Urodyn"}],"container-title":["Klinische P\u00e4diatrie"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2907-7807.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T22:34:33Z","timestamp":1784673273000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2907-7807"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,5]]},"references-count":16,"URL":"https:\/\/doi.org\/10.1055\/a-2907-7807","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0300-8630","1439-3824"],"issn-type":[{"value":"0300-8630","type":"print"},{"value":"1439-3824","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,7,5]]},"published":{"date-parts":[[2026,7,5]]}}}