[Influence of selected factors on the development of renal scars in children with vesico-ureteric complex]

Although relationship between vesico-ureteric reflux, urinary tract infection and renal scarring is known, pathogenesis of the renal scarring is still unclear. Vesico-ureteric reflux and urinary tract infection remain in very close relationship, they may also occur separately. The factor promoting renal injury is also young age of a child. The aim of this paper was to analyse the influence of the selected factors, namely: degree of the vesico-ureteric reflux; child's age at reflux diagnosis time as well as the frequency of recurrences of urinary tract infections exerted on reflux nephropathy. In 45 children with diagnosed vesicoureteric reflux the intensity of renal scarring was estimated using planar scintigraphy with DMSA-Tc-99m and a questionnaire was prepared. The questionnaire included information as follows: age at which the diagnosis was established, degree of reflux at the time of diagnosis, treatment applied, frequency of urinary tract infections before and after having taking medical care of children. It was revealed that the degree of scarring correlated with degree of vesico-ureteric reflux of particular kidney. In the investigated group no correlations were found between intensity of renal scarring and both the age of establishing diagnosis and frequency of urinary tract infections before starting the treatment. Taking the obtained results into consideration it seems, that the degree of vesico-ureteric reflux estimated prior to treatment determines degree of renal injuries though, undoubtedly all factors being studied affect renal scarring.