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[Pathogenetic bases for choosing treatment for vesicoureteral reflux in children]
Insights
This study followed 600 children with vesico-ureteral reflux (VUR) for up to 28 years. Findings specify kidney compensatory processes and guide VUR treatment based on cause and renal function loss.
Area of Science:
- Pediatric Urology
- Nephrology
- Developmental Biology
Context:
- Vesico-ureteral reflux (VUR) affects children, potentially leading to kidney damage.
- Long-term outcomes and compensatory mechanisms in pediatric VUR require further elucidation.
Purpose:
- To analyze the long-term course of compensatory processes in the kidneys of children with VUR.
- To correlate VUR causes and severity with renal function loss across different life stages.
- To inform treatment strategies for pediatric VUR based on morphological and etiological factors.
Summary:
- A 28-year follow-up of 600 children treated for VUR (ages 3 months to 15 years) was conducted.
- The study details kidney compensatory processes considering VUR causes and renal function decline from childhood to adulthood.
- Morphological assessment of renal parenchyma aids in selecting VUR treatments, particularly for ureteral malformations or bladder inflammation.
Impact:
- Provides insights into the natural history and long-term renal outcomes in pediatric VUR.
- Establishes a basis for tailored VUR management strategies in children.
- Highlights the importance of understanding VUR etiology and renal morphology for effective treatment planning.
Abstract:
600 children treated surgically or conservatively for vesico-ureteral reflux (VUR) at the age 3 months to 15 years were followed up for maximum 28 years. The course of compensatory processes in the kidney with considering the cause of VUR development at different stages of life (childhood, adolescence, adult life) and the degree of renal function loss were specified. Morphologic studies of renal parenchyma help choosing treatment of VUR in children depending on the cause of its development: malformation of ostium ureteris and intramural ureter, inflammation in the urinary bladder.