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Vesicoureteral reflux in children with and without a history of urinary tract infection: a comparative analysis
1Department of Urology, Children's Hospital of Buffalo, State University of New York.
Insights
Prospective screening identified significant vesicoureteral reflux (VUR) in children without urinary tract infections. Ultrasound alone proved inaccurate for diagnosing VUR or kidney scarring, highlighting the need for better diagnostic methods.
Area of Science:
- Pediatric Nephrology
- Urology
- Diagnostic Imaging
Background:
- Vesicoureteral reflux (VUR) is a common condition in children.
- Early detection and management are crucial to prevent kidney damage.
- Current diagnostic methods have limitations.
Purpose of the Study:
- To compare the characteristics of VUR in children diagnosed via screening versus those presenting with urinary tract infections (UTIs).
- To evaluate the diagnostic accuracy of ultrasound for VUR and renal scarring.
Main Methods:
- Prospective study of 88 children with VUR over two years.
- Comparison of two groups: 49 with UTI, 39 identified through screening.
- Assessment of VUR grade and parenchymal scarring.
- Evaluation of ultrasound accuracy.
Main Results:
- VUR severity was comparable between screened and UTI groups.
- More males with VUR identified in the screened group.
- Ultrasound demonstrated high inaccuracy in identifying VUR and scarring.
Conclusions:
- Screening at-risk children without UTIs can identify clinically significant VUR.
- Ultrasound alone is insufficient for diagnosing VUR and renal scarring.
- Further research into improved diagnostic tools for VUR is warranted.
Abstract:
Eighty-eight children who were discovered to have vesicoureteral reflux were prospectively studied over a two-year period. Two groups were compared: 49 who presented with a urinary tract infection and 39 who were identified through prospective screening. Based on the distribution of grade and the presence of parenchymal scarring, the severity of vesicoureteral reflux was comparable in the two groups. Of note, more males with reflux were identified in the noninfected group, whereas sex distribution was almost equal in the infected group. Ultrasound alone was found to be highly inaccurate in identifying reflux or parenchymal changes. In conclusion, screening of at-risk groups of children without a history of urinary tract infection may identify patients with clinically significant vesicoureteral reflux.