Age at diagnosis of vesicoureteric reflux after urinary infections: historical changes

Area of Science:

• Pediatric Nephrology
• Urology
• Diagnostic Imaging

Background:

• Vesicoureteric reflux (VUR) can lead to kidney scarring and damage if not detected early after urinary tract infections.
• Guidelines recommend prompt VUR detection to mitigate secondary renal damage in children.
• Implementing these recommendations is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the practical implementation of VUR detection guidelines.
• To evaluate the impact of these guidelines on the age of VUR diagnosis.
• To compare current VUR diagnosis ages with historical data and international benchmarks.

Main Methods:

• Retrospective analysis of 126 patients diagnosed with VUR between 1976 and 1999 at a Milan tertiary center.
• Comparison of diagnostic age data with a historical cohort of 102 patients from Melbourne (1946-1970).
• Statistical analysis to determine significant differences in age at diagnosis based on birth year and gender.

Main Results:

• Median age of VUR diagnosis significantly decreased from 34 months (pre-1988) to 8 months (post-1988) in Milan.
• This trend was more pronounced in females than males.
• Milan's current diagnosis ages (<1 year for boys, 1-2 years for girls) are significantly earlier than Melbourne's historical data (1-2 years for boys, 5-6 years for girls).

Conclusions:

• VUR diagnosis in Milan has become significantly earlier over time, especially post-1988.
• While improvements are noted, particularly in females, earlier diagnosis in boys remains an area for focus.
• The study highlights successful guideline implementation and the need for continued vigilance in pediatric VUR management.