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Body growth in early diagnosed vesicoureteric reflux
C Polito1, A La Manna, L Mansi
1Department of Pediatrics, 3rd Pediatric Clinic, Second University of Naples, Naples, Italy.
Insights
Children with prenatal vesicoureteric reflux (VUR) receiving early antibiotics show normal body growth, even with persistent VUR. Early intervention ensures healthy development in pediatric VUR patients.
Area of Science:
- Pediatric Nephrology
- Urology
- Developmental Pediatrics
Background:
- Vesicoureteric reflux (VUR) is a common condition in children.
- Prenatal detection of urinary tract dilatation often leads to VUR diagnosis.
- The impact of early management on growth in VUR is crucial.
Purpose of the Study:
- To evaluate body growth in infants with prenatally detected VUR and normal renal function.
- To compare growth outcomes between prenatally detected VUR and VUR diagnosed post-neonatally.
- To assess the efficacy of early antibacterial prophylaxis on growth in VUR.
Main Methods:
- Longitudinal study of 32 infants with prenatally detected VUR on early antibacterial prophylaxis.
- Comparison of growth parameters (height Z score, weight-for-height index) with 94 VUR patients diagnosed post-neonatally.
- Follow-up duration of 1-5 years (mean 2.3 years).
Main Results:
- No infants with prenatally detected VUR had height Z scores below -2 or weight-for-height index below 90%.
- Only 1 infant (3.1%) with prenatally detected VUR experienced significant height Z score variations (> /=1).
- This contrasts significantly with 21.3% of post-neonatally diagnosed VUR patients showing similar growth variations (P=0.035).
Conclusions:
- Early antibacterial prophylaxis in infants with prenatally detected VUR and normal renal function supports normal body growth.
- Persistent VUR in this cohort did not impede normal physical development.
- Timely intervention in pediatric VUR is vital for ensuring healthy growth trajectories.
Abstract:
Body growth was studied in 32 subjects with vesicoureteric reflux (VUR), diagnosed following the prenatal finding of urinary tract dilatation, who had normal renal filtration function and who received antibacterial prophylaxis by the first few days of life. They were followed for 1-5 years (mean 2.3 years). Most had persistent VUR during the 1st year of life. Body growth performance was compared with that of 94 subjects with VUR diagnosed and treated by us after the neonatal period. During the follow-up period, none of the patients with prenatally detected VUR had a height Z score below -2, nor a weight-for-height index below 90%, and 1 had variations in height Z score >/=1. The difference in the percentage of patients with prenatally detected VUR (1/32) and those with VUR diagnosed and treated after the neonatal period (20/94) who had variations in height Z score >/=1 was significant (P=0.035). Patients with prenatally detected VUR and normal renal filtration function, given antibacterial prophylaxis by the first few days of life, have normal body growth, although VUR still persists.