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[Prognosis in vesicoureteral reflux]
E Cemerlić-Zecević1, D Miliclc, S Uzicanin
1Pedijatrijska klinika, Klinicki centar Univerziteta u Sarajevu.
Insights
Early diagnosis of Vesicoureteric Reflux (VUR) is crucial for preventing kidney failure in children. Prompt treatment can reduce the risk of renal scarring, especially in younger patients.
Area of Science:
- Pediatric Nephrology
- Urology
- Diagnostic Imaging
Context:
- Vesicoureteric Reflux (VUR) is a significant risk factor for pediatric kidney damage.
- Early detection of VUR is essential for preventing long-term renal complications.
- Urinary tract infections (UTIs) in children often warrant investigation for underlying VUR.
Purpose:
- To highlight the critical role of early VUR diagnosis in preventing renal failure.
- To underscore the importance of timely intervention in pediatric VUR cases.
- To emphasize the link between VUR, renal scarring, and potential kidney damage.
Summary:
- This study followed 31 pediatric nephrology patients (ages 0-15) diagnosed with VUR.
- Micturating cystourethrography (MCGU) and dimercaptosuccinic acid (DMSA) scans were used to assess VUR and renal damage.
- Results indicated renal scarring in 16 kidneys among children under 7, particularly with higher-grade VUR.
Impact:
- Early VUR diagnosis and treatment can significantly mitigate the risk of renal scarring and subsequent renal failure.
- Younger children with VUR face a higher likelihood of developing renal scars if not managed appropriately.
- This research reinforces the need for vigilant screening and management of VUR in pediatric populations.
Objectives:
To emphasise the importance of early diagnosis of Vesicoureteric Reflux (VUR) in prevention of renal failure.
Methods:
General testing of children was followed by micturating cystourethrography (MCGU) for those with the diagnosis of urinary-tract infection. In cases where high level of VUR was determined, satic nuclear medicine scanning was performed using an isotope-labeled substance (e.g. DMSA).
Results:
31 nephrology department patients were followed: 29 girls, 2 boys ages 0-15. MCGU showed 33 kidneys with reflux. 13 of the patients had reflux in the first or second degree. 7 patients showed reflux of the 2-3 degree while 13 had a high degree of reflux. Among the children under 7 years of age, total of 16 kidneys, DMSA showed various degrees of damage to the paranhaim and the development of scars.
Conclusion:
After the VUR has been diagnosed, it is difficult to predict whether scarring will take place. The possibility of scarring is higher among younger children when appropriate therapeutic modalities are not identified.