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Ensuring our exstrophy-epispadias complex patients and families thrive

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Abstract

Individuals with bladder exstrophy-epispadias complex (EEC) need long-term integrated medical/surgical and psychosocial care. These individuals are at risk for medical and surgical complications and experience social and psychological obstacles related to their genitourinary anomaly. This care needs to be accessible, comprehensive, and coordinated. Multiple surgical interventions, reoccurring hospitalizations, urinary and fecal incontinence, extensive treatment regimens for continent diversions, genital differences, and sexual health implications affect the quality of life for the EEC patient. Interventions must include psychosocial support, medical literacy initiatives, behavioral health services, school and educational consultation, peer-to-peer opportunities, referrals to disease-specific camps, mitigation of adverse childhood events (ACEs), formal transition of care to adult providers, family and teen advisory opportunities, and clinical care coordination. The priority of long-term kidney health will necessitate strong collaboration among urology and nephrology teams. Given the rarity of these conditions, multi-center and global efforts are paramount in the trajectory of improving care for the EEC population. To achieve the highest standards of care and ensure that individuals with EEC can thrive in their environment, multidisciplinary and integrated medical/surgical and psychosocial services are imperative.

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References

  1. Jayachandran D, Bythell M, Platt MW, Rankin J (2011) Register based study of bladder exstrophy-epispadias complex: prevalence, associated anomalies, prenatal diagnosis and survival. J Urol 186:2056–2060. https://doi.org/10.1016/j.juro.2011.07.022

    Article  CAS  PubMed  Google Scholar 

  2. Nelson CP, Dunn RL, Wei JT (2005) Contemporary epidemiology of bladder exstrophy in the United States. J Urol 173:1728–1731. https://doi.org/10.1097/01.ju.0000154821.21521.9b

    Article  PubMed  Google Scholar 

  3. Borer JG (2021) Clinical manifestations and initial management of infants with bladder exstrophy. Uptodate: Waltham, MA. https://www.uptodate.com/contents/clinical-manifestations-and-initial-management-of-infants-with-bladder-exstrophy?search=clinical%20manifestations%20bladder%20exstrophy&source=search_result&selectedTitle=1~26&usage_type=default&display_rank=1. Accessed January 9, 2023.

  4. Ebert A, Reutter H, Ludwig M, Rösch WH (2009) The exstrophy-epispadias complex. Orphanet J Rare Dis 4:23. https://doi.org/10.1186/1750-1172-4-23

    Article  PubMed  PubMed Central  Google Scholar 

  5. Woo LL, Thomas JC, Brock JW (2010) Cloacal exstrophy: a comprehensive review of an uncommon problem. J Pediatr Urol 6:102–111. https://doi.org/10.1016/j.jpurol.2009.09.011

    Article  PubMed  Google Scholar 

  6. Anderson DL, Murray CD, Hurrell R (2013) Experiences of intimacy among people with bladder exstrophy. Qual Health Res 23:1600–1612. https://doi.org/10.1177/1049732313509409

    Article  PubMed  Google Scholar 

  7. Deans R, Liao L, Wood D, Woodhouse C, Creighton SM (2015) Sexual function and health-related quality of life in women with classic bladder exstrophy. BJU Int 115:633–638. https://doi.org/10.1111/bju.12811

    Article  PubMed  Google Scholar 

  8. Dellenmark-Blom M, Sjöström S, Abrahamsson K, Holmdahl G (2019) Health-related quality of life among children, adolescents, and adults with bladder exstrophy-epispadias complex: a systematic review of the literature and recommendations for future research. Qual Life Res 28:1389–1412. https://doi.org/10.1007/s11136-019-02119-7

    Article  PubMed  Google Scholar 

  9. Baird AD (2011) Exstrophy in the adolescent and young adult population. Semin Pediatr Surg 20:109–112. https://doi.org/10.1053/j.sempedsurg.2010.12.006

    Article  PubMed  Google Scholar 

  10. Pennison MC, Mednick L, Rosoklija I, Grant R, Price D, Huang L, Ziniel S, Borer JG (2014) Health related quality of life in patients with bladder exstrophy: a call for targeted interventions. J Urol 191:1553–1557. https://doi.org/10.1016/j.juro.2013.09.089

    Article  PubMed  Google Scholar 

  11. Lee C, Reutter HM, Grässer MF, Fisch M, Noeker M (2006) Gender-associated differences in the psychosocial and developmental outcome in patients affected with the bladder exstrophy-epispadias complex. BJU Int 97:349–353. https://doi.org/10.1111/j.1464-410x.2005.05910.x

    Article  PubMed  Google Scholar 

  12. Holmdahl G, Dellenmark-Blom M, Nordenskjöld A, Sjöström S (2020) Health-related quality of life in patients with the bladder exstrophy-epispadias complex and relationship to incontinence and sexual factors: a review of the recent literature. Eur J Pediatr Surg 30:251–260. https://doi.org/10.1055/s-0040-1713178

    Article  PubMed  Google Scholar 

  13. Brenner M, Kidston C, Hilliard C, Coyne I, Eustace-Cook J, Doyle C, Begley T, Barrett MJ (2018) Children’s complex care needs: a systematic concept analysis of multidisciplinary language. Eur J Pediatr 177:1641–1652. https://doi.org/10.1007/s00431-018-3216-9

    Article  PubMed  Google Scholar 

  14. Style CC, Hsu DM, Verla MA, Mittal AG, Austin P, Seth A, Dietrich JE, Adeyemi-Fowode OA, Bercaw-Pratt JL, Chiou EH, Chumpitazi BP, Akalonu A, Victorian VA, Denner FR, Borden AN, Levitt MA, Grooms JR, Frazier GG, Rialon KL, Lee TC (2020) Development of a multidisciplinary colorectal and pelvic health program: program implementation and clinical impact. J Pediatr Surg 55:2397–2402. https://doi.org/10.1016/j.jpedsurg.2020.05.002

    Article  PubMed  Google Scholar 

  15. Bujons A, Lopategui DM, Rodríguez N, Centeno C, Caffaratti J, Villavicencio H (2016) Quality of life in female patients with bladder exstrophy-epispadias complex: long-term follow-up. J Pediatr Urol 12:210.e1-210.e6. https://doi.org/10.1016/j.jpurol.2016.05.005

    Article  PubMed  Google Scholar 

  16. da Cruz J, Shiomi A, de Mattos B, Srougi M, Nguyen H, Bonan R, Denes F, Giron A, Passerotti C (2016) Quality of life in young adult patients treated for bladder exstrophy. Cent Eur J Urol 69:221–224. https://doi.org/10.5173/ceju.2016.715

    Article  Google Scholar 

  17. Di Grazia M, Pellizzoni S, Tonegatti LG, Rigamonti W (2017) Qualitative questionnaire on the psychosocial wellbeing of mothers of children with BEEC. J Pediatr Urol 13:55.e1-55.e6. https://doi.org/10.1016/j.jpurol.2016.07.015

    Article  PubMed  Google Scholar 

  18. Grano C, Fernandes M, Aminoff D, Bucci S, Lucidi F, Violani C (2016) The role of coping strategies on health-related quality of life in adults with anorectal malformations. Pediatr Surg Int 32:759–765. https://doi.org/10.1007/s00383-016-3911-4

    Article  CAS  PubMed  Google Scholar 

  19. Reiner WG, Gearhart JP (2006) Anxiety disorders in children with epispadias-exstrophy. Urology 68:172–174. https://doi.org/10.1016/j.urology.2006.01.056

    Article  PubMed  Google Scholar 

  20. Satish Kumar KV, Mammen A, Varma KK (2015) Pathogenesis of bladder exstrophy: a new hypothesis. J Pediatr Urol 11:314–318. https://doi.org/10.1016/j.jpurol.2015.05.030

    Article  Google Scholar 

  21. Ludwig M, Ching B, Reutter H, Boyadjiev SA (2009) Bladder exstrophy-epispadias complex. Birth Defects Res A Clin Mol Teratol 85:509–522. https://doi.org/10.1002/bdra.20557

    Article  CAS  PubMed  Google Scholar 

  22. Borer JG (2021) Surgical management and postoperative outcome of children with bladder exstrophy. UpToDate. https://www.uptodate.com/contents/surgical-management-and-postoperative-outcome-of-children-with-bladder-exstrophy?search=bladder%20exstrophy&source=search_result&selectedTitle=2~26&usage_type=default&display_rank=2. Accessed January 9, 2023.

  23. Grady RW, Mitchell ME (1999) Complete primary repair of exstrophy. J Urol 162:1415–1420. https://doi.org/10.1016/S0022-5347(05)68327-9

    Article  CAS  PubMed  Google Scholar 

  24. Borer JG, Vasquez E, Canning DA, Kryger JV, Mitchell ME (2015) An initial report of a novel multi-institutional bladder exstrophy consortium: a collaboration focused on primary surgery and subsequent care. J Urol 193:1802–1807. https://doi.org/10.1016/j.juro.2014.10.114

    Article  PubMed  Google Scholar 

  25. Mathews R, Gearhart JP (2005) Modern staged reconstruction of bladder exstrophy–still the gold standard. Urology 65:2–4. https://doi.org/10.1016/j.urology.2004.07.029

    Article  PubMed  Google Scholar 

  26. Tirrell TF, Demehri FR, Henry OS, Cullen L, Lillehei CW, Warf BC, Gates RL, Borer JG, Dickie BH (2021) Safety of delayed surgical repair of omphalocele-exstrophy-imperforate anus-spinal defects (OEIS) complex in infants with significant comorbidities. Pediatr Surg Int 37:93–99. https://doi.org/10.1007/s00383-020-04779-w

    Article  PubMed  Google Scholar 

  27. Woodhouse CRJ, North AC, Gearhart JP (2006) Standing the test of time: Long-term outcome of reconstruction of the exstrophy bladder. World J Urol 24:244–249. https://doi.org/10.1007/s00345-006-0053-7

    Article  CAS  PubMed  Google Scholar 

  28. Ebert AK, Schott G, Bals-Pratsch M, Seifert B, Rosch WH (2010) Long-term follow-up of male patients after reconstruction of the bladder-exstrophy-epispadias complex: psychosocial status, continence, renal and genital function. J Pediatr Urol 6:6–10. https://doi.org/10.1016/j.jpurol.2009.06.002

    Article  PubMed  Google Scholar 

  29. Amesty MV, Chocarro G, Lobato R, Monsalve S, Martinez-Urrutia MJ, Lopez-Pereira PC, Jaureguizar E (2016) Quality of life in female epispadias. Eur J Pediatr Surg 26:277–281. https://doi.org/10.1055/s-0035-1554793

    Article  PubMed  Google Scholar 

  30. Wilson C, Christie D, Woodhouse CRJ (2004) The ambitions of adolescents born with exstrophy: a structured survey. BJU Int 94:607–612; discussion 612. https://doi.org/10.1111/j.1464-410x.2004.05010.x

  31. Wood D, Baird A, Carmignani L, De Win G, Hoebeke P, Holmdahl G, Manzoni G, Nijman RJM, Taylor C, Tekgul S (2019) Lifelong congenital urology: the challenges for patients and surgeons. Eur Urol 75:1001–1007. https://doi.org/10.1016/j.eururo.2019.03.019

    Article  PubMed  Google Scholar 

  32. Erickson SJ, Gerstle M, Feldstein SW (2005) Brief interventions and motivational interviewing with children, adolescents, and their parents in pediatric health care settings: a review. Arch Pediatr Adolesc Med 159:1173–1180. https://doi.org/10.1001/archpedi.159.12.1173

    Article  PubMed  Google Scholar 

  33. Eyer de Jesus L, Dekermacher S, Pippi-Salle JL (2022) Bladder exstrophy: we need to improve. A lot. J Pediatr Urol 18:38.e1-38.e11. https://doi.org/10.1016/j.jpurol.2021.11.007

    Article  PubMed  Google Scholar 

  34. Mednick L, Gargollo P, Oliva M, Grant R, Borer J (2009) Stress and coping of parents of young children diagnosed with bladder exstrophy. J Urol 181:1312–1316; discussion 1317. https://doi.org/10.1016/j.juro.2008.10.051

  35. Jana A, Maiti K, Mondal TK, Majhi TK (2017) Management of the exstrophy-epispadias complex in adolescents and adults. Afr J Urol 23:100–104. https://doi.org/10.1016/j.afju.2016.09.001

    Article  Google Scholar 

  36. Cleper R, Blumenthal D, Beniamini Y, Friedman S, Yosef YB, Chaim JB (2023) Exstrophy-epispadias complex: are the kidneys and kidney function spared? Pediatr Nephrol. https://doi.org/10.1007/s00467-023-05889-y

    Article  PubMed  Google Scholar 

  37. Calderon-Margalit R, Golan E, Twig G, Leiba A, Tzur D, Afek A, Skorecki K, Vivante A (2018) History of childhood kidney disease and risk of adult end-stage renal disease. N Engl J Med 378:428–438. https://doi.org/10.1056/nejmoa1700993

    Article  PubMed  Google Scholar 

  38. Catti M, Paccalin C, Rudigoz R, Mouriquand P (2006) Quality of life for adult women born with bladder and cloacal exstrophy: a long-term follow up. J Pediatr Urol 2:16–22. https://doi.org/10.1016/j.jpurol.2005.07.002

    Article  PubMed  Google Scholar 

  39. Hayes LC, Meers A, Tulley K, Sable PE, Castagno S, Cilento BG (2022) Interdisciplinary collaboration in a pediatric urology outpatient clinic at a tertiary children’s hospital: a case series. Urology 169:191–195. https://doi.org/10.1016/j.urology.2022.07.036

    Article  PubMed  Google Scholar 

  40. Mobach L, Oar E, Hudson JL (2020) Exposure therapy for specific phobias in children and adolescents. In: Peris TS, Storch EA, McGuire JF (eds) Exposure therapy for children with anxiety and OCD: Clinician’s guide to integrated treatment. Academic Press, London, pp 165–191

    Chapter  Google Scholar 

  41. Orenius T, LicPsych SH, Mikola K, Ristolainen L (2018) Fear of injections and needle phobia among children and adolescents: an overview of psychological, behavioral, and contextual factors. SAGE Open Nurs 4:2377960818759442. https://doi.org/10.1177/2377960818759442

    Article  PubMed  PubMed Central  Google Scholar 

  42. Ng CZ, Tang SC, Chan M, Tran BX, Ho CS, Tam WW, Ho RC (2019) A systematic review and meta-analysis of randomized controlled trials of cognitive behavioral therapy for hemodialysis patients with depression. J Psychosom Res 126:109834. https://doi.org/10.1016/j.jpsychores.2019.109834

    Article  PubMed  Google Scholar 

  43. Rohan JM, Verma T (2020) Psychological considerations in pediatric chronic illness: case examples. Int J Environ Res Public Health 17:1644. https://doi.org/10.3390/ijerph17051644

    Article  PubMed  PubMed Central  Google Scholar 

  44. Tok ESS (2018) Cognitive behavioral therapy principles in children: treatment of internalizing disorders. In: Omar Senormanci and Guliz Senormanci, eds. Cognitive Behavioral Therapy and Clinical Applications. InTechOpen, Rijeka, Croatia, pp 1–25

  45. Dindo L, Van Liew JR, Arch JJ (2017) Acceptance and commitment therapy: a transdiagnostic behavioral intervention for mental health and medical conditions. Neurotherapeutics 14:546–553. https://doi.org/10.1007/s13311-017-0521-3

    Article  PubMed  PubMed Central  Google Scholar 

  46. Edwards M, Borzyskowski M, Cox A, Badcock J (2004) Neuropathic bladder and intermittent catheterization: social and psychological impact on children and adolescents. Dev Med Child Neurol 46:168–177. https://doi.org/10.1017/s0012162204000301

    Article  PubMed  Google Scholar 

  47. DeMaso DR, Snell C (2013) Promoting coping in children facing pediatric surgery. Semin Pediatr Surg 22:134–138. https://doi.org/10.1053/j.sempedsurg.2013.04.004

    Article  PubMed  Google Scholar 

  48. National Child Traumatic Stress Network (NCTSN) (2014) Pediatric medical traumatic stress: a comprehensive guide. For health care providers. National Child Traumatic Stress Network. https://www.nctsn.org/sites/default/files/resources//pediatric_toolkit_for_health_care_providers.pdf. Accessed January 9, 2023

  49. Kazak AE, Kassam-Adams N, Schneider S, Zelikovsky N, Alderfer MA, Rourke M (2006) An integrative model of pediatric medical traumatic stress. J Pediatr Psychol 31:343–355. https://doi.org/10.1093/jpepsy/jsj054

    Article  PubMed  Google Scholar 

  50. Kain ZN, Caldwell-Andrews AA, Mayes LC, Weinberg ME, Wang S, MacLaren JE, Blount RL (2007) Family-centered preparation for surgery improves perioperative outcomes in children: a randomized controlled trial. Anesthesiology 106:65–74. https://doi.org/10.1097/00000542-200701000-00013

    Article  PubMed  Google Scholar 

  51. Racine NM, Riddell RRP, Khan M, Calic M, Taddio A, Tablon P (2016) Systematic review: predisposing, precipitating, perpetuating, and present factors predicting anticipatory distress to painful medical procedures in children. J Pediatr Psychol 41:159–181. https://doi.org/10.1093/jpepsy/jsv076

    Article  PubMed  Google Scholar 

  52. American Academy of Pediatrics Council on Children with Disabilities (2005) Care coordination in the medical home: Integrating health and related systems of care for children with special health care needs. Pediatrics 116:1238–1244. https://doi.org/10.1542/peds.2005-2070

    Article  Google Scholar 

  53. Apple RW (2017) Children and adolescents coping with chronic illness and disability. Int J Child Adolesc Health 10:495–508

    Google Scholar 

  54. Mauro T (2022) 504 plans for students with disabilities: for children who need accommodations in the classroom. verywell family. https://www.verywellfamily.com/what-is-a-504-plan-3104706. Accessed 29 December 2022

  55. Jordan V, Prideaux R (2018) Access to quality education for children with special educational needs. Eur Platform Invest Child (EPIC) 833:1–8

    Google Scholar 

  56. van der Pol S, Postma MJ, Jansen, Danielle EMC (2020) School health in Europe: a review of workforce expenditure across five countries. BMC Health Serv Res 20:206–020–05077-w. https://doi.org/10.1186/s12913-020-05077-w

  57. U. S. Department of Education. Office for Civil Rights (2020) Impact of the civil rights laws. U. S. Department of Education. Office for Civil Rights. https://www2.ed.gov/about/offices/list/ocr/impact.html. Accessed 29 December, 2022

  58. Filce HG, Lavergne L (2011) Educational needs and accommodations for children with bowel and/or bladder dysfunction. Phys Disabil Educ Relat Serv 30:30–52

    Google Scholar 

  59. Bauer SB, Choung K, Sable P, Dykeman B, Venna A, Shanahan M, Sexton K, Price D, Christiansen S, Sullivan K (May 2020) The psychosocial impact of clean intermittent catheterization on patients families: effect on education and school environment. Oral presentation at The Societies for Pediatric Urology; Virtual presentation.

  60. Scheel A, Beaton A, Okello E, Longenecker CT, Otim IO, Lwabi P, Sable C, Webel AR, Aliku T (2018) The impact of a peer support group for children with rheumatic heart disease in Uganda. Patient Educ Couns 101:119–123. https://doi.org/10.1016/j.pec.2017.07.006

    Article  PubMed  Google Scholar 

  61. Scheurer D, Choudhry N, Swanton KA, Matlin O, Shrank W (2012) Association between different types of social support and medication adherence. Am J Manag Care 18:e461–e467

    PubMed  Google Scholar 

  62. Finlay KA, Elander J (2016) Reflecting the transition from pain management services to chronic pain support group attendance: an interpretative phenomenological analysis. Br J Health Psychol 21:660–676. https://doi.org/10.1111/bjhp.12194

    Article  PubMed  Google Scholar 

  63. Kaufman N (2022) Peer-to-peer support helps people improve their chronic condition therapy outcomes. Canary Health Chronic Disease Programs. https://www.canaryhealth.com/peer-to-peer-support-imporves-chronic-condition-therapy-neal-author/. Accessed January 9, 2023

  64. Price D, Grant R, Anderson L (2016) I don’t believe everyone here has bladder exstrophy: one hospital’s experience with support group services. Dialogues Pediatr Urol 37:5–6

    Google Scholar 

  65. Bethell CD, Solloway MR, Guinosso S, Hassink S, Srivastav A, Ford D, Simpson LA (2017) Prioritizing possibilities for child and family health: an agenda to address adverse childhood experiences and foster the social and emotional roots of well-being in pediatrics. Acad Pediatr 17:S36–S50. https://doi.org/10.1016/j.acap.2017.06.002

    Article  PubMed  Google Scholar 

  66. Petruccelli K, Davis J, Berman T (2019) Adverse childhood experiences and associated health outcomes: a systematic review and meta-analysis. Child Abuse Negl 97:104127. https://doi.org/10.1016/j.chiabu.2019.104127

    Article  PubMed  Google Scholar 

  67. Zdunek K, Schröder-Bäck P, Alexander D, Rigby M, Blair M (2019) Contextual determinants of CHILDREN’S health care and policy in Europe. BMC Public Health 19:839–019–7164–8. https://doi.org/10.1186/s12889-019-7164-8

  68. Frederick J, Spratt T, Devaney J (2021) Adverse childhood experiences and social work: relationship-based practice responses. Br J Soc Work 51:3018–3034. https://doi.org/10.1093/bjsw/bcaa155

  69. Castillo C, Kitsos E (2017) Transitions from pediatric to adult care. Global Pediatric Health 4:2333794X17744946. https://doi.org/10.1177/2333794X17744

  70. Bond J, Shanske S, Hoffman R, Ross AM (2020) Piloting a structured developmental tool to assess transition readiness for youth with special health-care needs: a mixed-methods exploration of health-care provider experiences. J Child Health Care 24:92–105. https://doi.org/10.1177/1367493518823899

    Article  PubMed  Google Scholar 

  71. Martinez LM, Slobodov G, Lewis J, Haddad E, Frimberger D (2016) Transition of care for adults with congenital urological conditions. Curr Treat Options Pediatr 2:35–42. https://doi.org/10.1007/s40746-016-0040-1

    Article  Google Scholar 

  72. Taloney L, Flores G (2013) Building blocks for successful patient and family advisory boards: collaboration, communication, and commitment. Nurs Adm Q 37:247–253. https://doi.org/10.1097/naq.0b013e318295ed58

    Article  PubMed  Google Scholar 

  73. Rich C, Goncalves A, Guardiani M, O’Donnell E, Strzelecki J (2014) Teen advisory committee: lessons learned by adolescents, facilitators, and hospital staff. Pediatr Nurs 40:289–296

    PubMed  Google Scholar 

  74. Joshi RS, Shrivastava D, Grady R, Kundu A, Ramji J, Reddy PP, Pippi-Salle JL, Frazier JR, Canning DA, Shukla AR (2018) A model for sustained collaboration to address the unmet global burden of bladder exstrophy-epispadias complex and penopubic epispadias: the international bladder exstrophy consortium. JAMA Surg 153:618–624. https://doi.org/10.1001/jamasurg.2018.0067

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

We dedicate this review to the memory of Barbara Neilson MSW, RES. Dip S.W., RSW, Douglas A. Canning, MD, Blake W. Palmer MD, and Martin Situma MD who were leaders in EEC care, colleagues, mentors, and a source of inspiration for this review.

We acknowledge and are grateful for the contributions of Pamela Artigas, executive director of the Association for the Bladder Exstrophy Community (A-BE-C), and Dena Hanson MLS, AHIP, Cook Children’s Health Care System.

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  1. Cook Children’s Health Care System, Fort Worth, TX, USA

    Emily Haddad

  2. Department of Urology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Lillian C. Hayes, Diane Price, Christina G. Vallery & Joseph G. Borer

  3. Department of Nephrology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Michael Somers

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Haddad, E., Hayes, L.C., Price, D. et al. Ensuring our exstrophy-epispadias complex patients and families thrive. Pediatr Nephrol 39, 371–382 (2024). https://doi.org/10.1007/s00467-023-06049-y

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