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A Murine Model of Irreversible and Reversible Unilateral Ureteric Obstruction
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Renal parenchymal damage in sibling vesicoureteric reflux

S Cascio1, A Yoneda, B Chertin

  • 1The National Children's Hospital, Dublin, Ireland.

Acta Paediatrica (Oslo, Norway : 1992)
|March 26, 2003
PubMed

Insights

Siblings with a history of urinary tract infections (UTI) show higher rates of mild renal scarring from vesicoureteric reflux (VUR). Asymptomatic siblings with VUR had comparable moderate to severe renal scarring.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Genetics

Background:

  • Vesicoureteric reflux (VUR) is a condition where urine flows backward from the bladder to the ureters.
  • Renal damage can occur in children with VUR, particularly after urinary tract infections (UTIs).
  • Screening for hereditary VUR in siblings of affected patients is crucial for early detection and management.

Purpose of the Study:

  • To compare the incidence and severity of renal damage in siblings with a history of UTI versus asymptomatic siblings diagnosed with VUR through screening.
  • To evaluate the long-term implications of VUR presentation on renal health in pediatric patients.

Main Methods:

  • Retrospective review of medical and radiological records of VUR patients and their siblings diagnosed between 1990 and 2000.
  • Analysis of presentation mode (UTI vs. screening), VUR grade, and presence of renal damage using dimercaptosuccinic acid (DMSA) scans.
  • Comparison of reflux nephropathy rates between symptomatic and asymptomatic siblings.

Main Results:

  • Vesicoureteric reflux (VUR) was identified in 226 siblings across 107 families.
  • Reflux nephropathy was significantly higher in siblings presenting with UTI (26%) compared to asymptomatic screened siblings (7%).
  • Mild renal damage was more prevalent in siblings with UTI (21%) than in screened siblings (2%), while moderate to severe damage showed no significant difference.

Conclusions:

  • The incidence of mild renal scarring is significantly higher in siblings presenting with a urinary tract infection (UTI) compared to asymptomatic siblings.
  • Moderate to severe renal scarring rates were comparable between symptomatic and asymptomatic siblings with VUR.
  • Early detection and management of VUR in siblings, regardless of UTI history, are important for preventing renal damage.
Abstract

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