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Related Experiment Videos

Renal damage in vesico-ureteric reflux.

P Caione1, G Ciofetta, G Collura

  • 1Division of Paediatric Urology, Department of Nephrology and Urology, Bambino Gesù Children's Hospital, Research Institute, Rome, Italy. caione@opbg.net

BJU International
|March 11, 2004
PubMed
Summary

Vesico-ureteric reflux (VUR) often causes renal parenchymal damage, with reduced kidney function worsening with reflux severity. This study highlights VUR

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Area of Science:

  • Pediatric Nephrology
  • Radiology
  • Urology

Background:

  • Primary vesico-ureteric reflux (VUR) is a common condition in children.
  • Renal parenchymal damage is a significant complication of VUR.
  • Understanding the patterns and extent of damage is crucial for management.

Purpose of the Study:

  • To determine the extent of renal parenchymal involvement in primary VUR.
  • To analyze the relationship between VUR grade, patient age, and patterns of renal damage.
  • To evaluate renal function using 99mTc-DMSA scintigraphy.

Main Methods:

  • Retrospective analysis of 197 children with primary VUR.
  • Voiding cysto-urethrography (VCUG) and 99mTc-dimercaptosuccinic acid (DMSA) renal scintigraphy were performed.

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  • DMSA scans classified into single scar (SS), multiple scarring (MS), or diffuse reduced uptake with small renal size.
  • Main Results:

    • 67% of refluxing units showed renal damage, compared to 16% of non-refluxing units.
    • Absolute uptake (AU) decreased significantly with increasing VUR grade (P < 0.001).
    • Severe VUR (grade 4-5) was associated with multiple scarring (MS) and reduced renal size, particularly in younger children (< 2 years).

    Conclusions:

    • VUR is frequently associated with renal parenchymal damage.
    • Renal function (AU) declines progressively with VUR severity.
    • Severe VUR leads to more extensive scarring and reduced kidney size, impacting function.