Interobserver variability for interpretation of DMSA scans in the RIVUR trial.

Introduction: Technetium-99m dimercaptosuccinic acid (DMSA) renal scans are used in the diagnosis of renal scarring. In the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial that randomized 607 children, DMSA renal scans were used for evaluating the presence and the severity of renal scarring.

Objective: The aim was to determine interobserver variability in reporting of DMSA renal scans in the RIVUR trial.

Reliability of grading of vesicoureteral reflux and other findings on voiding cystourethrography.

Introduction: Voiding cystourethrography (VCUG) is the modality of choice to diagnose vesicoureteral reflux (VUR). Although grading of VUR is essential for prognosis and clinical decision-making, the inter-observer reliability for grading has been shown to vary substantially. The Randomized Intervention for Children with VesicoUreteral Reflux (RIVUR) trial provides a large cohort of children with VUR to better understand the reliability of VCUG findings.

Antimicrobial Resistance and Urinary Tract Infection Recurrence.

Background: The Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial found that recurrent urinary tract infections (rUTI) with resistant organisms were more common in the trimethoprim-sulfamethoxazole prophylaxis (TSP) arm. We describe factors associated with trimethoprim-sulfamethoxazole (TMP-SMX) resistance of rUTIs in RIVUR.

Methods: Children aged 2 to 71 months with first or second UTI (index UTI) and grade I to IV vesicoureteral reflux (VUR) were randomized to TSP or placebo and followed for 2 years.

Predictors of Antimicrobial Resistance among Pathogens Causing Urinary Tract Infection in Children.

Objective: To determine which children with urinary tract infection are likely to have pathogens resistant to narrow-spectrum antimicrobials.

Study Design: Children, 2-71 months of age (n = 769) enrolled in the Randomized Intervention for Children with Vesicoureteral Reflux or Careful Urinary Tract Infection Evaluation studies were included. We used logistic regression models to test the associations between demographic and clinical characteristics and resistance to narrow-spectrum antimicrobials.

Knockout of the TauT gene predisposes C57BL/6 mice to streptozotocin-induced diabetic nephropathy.

Diabetic nephropathy is the leading cause of end stage renal disease in the world. Although tremendous efforts have been made, scientists have yet to identify an ideal animal model that can reproduce the characteristics of human diabetic nephropathy. In this study, we hypothesize that taurine insufficiency is a critical risk factor for development of diabetic nephropathy associated with diabetes mellitus.

Interactions of vitamin D and the proximal tubule.

Severe vitamin D deficiency (reduction in serum 25(OH)D concentration) in infants and children can cause features of the Fanconi syndrome, including phosphaturia, glycosuria, aminoaciduria, and renal tubular acidosis. This indicates that vitamin D and its metabolites influence proximal tubule function. Filtered 25(OH)D bound to vitamin D binding protein (DBP) is endocytosed by megalin-cubilin in the apical membrane.

The RIVUR trial: a factual interpretation of our data.

Vesicoureteral reflux (VUR) increases the risk of urinary tract infection (UTI) and renal scarring. Many prospective studies have evaluated the role of antimicrobial prophylaxis in the prevention of recurrent UTI and renal scarring in children with VUR. Of these, the RIVUR trial was the largest, randomized, placebo-controlled, double blind, multicenter study, involving 607 children aged 2-72 months with grade I-IV VUR and a first or second symptomatic UTI.

Antimicrobial prophylaxis for children with vesicoureteral reflux.

Background: Children with febrile urinary tract infection commonly have vesicoureteral reflux. Because trial results have been limited and inconsistent, the use of antimicrobial prophylaxis to prevent recurrences in children with reflux remains controversial.

Methods: In this 2-year, multisite, randomized, placebo-controlled trial involving 607 children with vesicoureteral reflux that was diagnosed after a first or second febrile or symptomatic urinary tract infection, we evaluated the efficacy of trimethoprim-sulfamethoxazole prophylaxis in preventing recurrences (primary outcome).

Development and impact of an intervention to boost recruitment in a multicenter pediatric randomized clinical trial.

Objectives: Our primary objective was to develop and evaluate an intervention to increase recruitment in a multicenter pediatric randomized clinical trial (RCT). Our secondary objective was to assess the impact beyond 120 days.

Methods: The study was conducted at 17 academic centers participating in a pediatric RCT.

The RIVUR trial: profile and baseline clinical associations of children with vesicoureteral reflux.

Background And Objective: Vesicoureteral reflux (VUR) is diagnosed in ∼30% to 40% of children who have imaging studies after urinary tract infections (UTIs). Our goal is to characterize children enrolled in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial and to compare our study cohort with those from previously published studies.

Methods: RIVUR investigators from 19 pediatric sites in the United States recruited 607 children with grade I through IV VUR.

Factors that influence parental decisions to participate in clinical research: consenters vs nonconsenters.

Importance: A child's health, positive perceptions of the research team and consent process, and altruistic motives play significant roles in the decision-making process for parents who consent for their child to enroll in clinical research. This study identified that nonconsenting parents were better educated, had private insurance, showed lower levels of altruism, and less understanding of study design.

Objective: To determine the factors associated with parental consent for their child's participation in a randomized, placebo-controlled trial.

Knockdown of TauT expression impairs human embryonic kidney 293 cell development.

Studies have demonstrated that TauT deficiency results in small kidneys in TauT knockout mice. Our studies have shown that TauT is a direct target of several genes, including p53 and WT1, which play an important role in renal development. However, whether the TauT gene is directly involved in renal development is largely unknown.

Differential regulation of TauT by calcitriol and retinoic acid via VDR/RXR in LLC-PK1 and MCF-7 cells.

The interaction between taurine and the absorption of fat-soluble -vitamins, such as vitamin A and D, has been an interesting topic in the field of -nutrition science, because taurine-conjugated bile acid optimizes fat and fat-soluble vitamin absorption. However, whether the hormone calcitriol (1,25-dihydroxyvitamin D(3)) and retinoic acid regulate the expression of the TauT gene is unknown. In this study, we test the hypothesis that the TauT gene is regulated by vitamin D(3) (VD(3)) and retinoic acid (RA) via activation of the vitamin D receptor (VDR) and retinoic acid receptor (RXR).

Rickets: Part I.

Rickets is characterized by impaired mineralization and ossification of the growth plates of growing children caused by a variety of disorders, the most frequent of which is nutritional deficiency of vitamin D. Despite ample knowledge of its etiology and the availability of cost-effective methods of preventing it, vitamin D deficiency rickets remains a significant problem in developing and developed countries. This two-part review covers the history, etiology, pathophysiology and clinical and radiographical findings of vitamin D deficiency rickets.

Rickets: Part II.

This is the continuation of a two-part review of rickets. This part emphasizes the specific pathophysiology, clinical features, pathoanatomy and radiographic findings of vitamin D deficiency rickets. Other forms of rickets, differential diagnostic considerations and the potential relationship between low levels of vitamin D metabolites and unexplained fractures in infants are also discussed.

Childhood vesicoureteral reflux studies: registries and repositories sources and nosology.

Despite several recent studies, the advisability of antimicrobial prophylaxis and certain imaging studies for urinary tract infections (UTIs) remains controversial. The role of vesicoureteral reflux (VUR) on the severity and re-infection rates for UTIs is also difficult to assess. Registries and repositories of data and biomaterials from clinical studies in children with VUR are valuable.