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[Severe primary vesicoureteral reflux in infants. A follow-up of 203 cases]

R Areses1, D Arruebarrena, M A Urbieta

  • 1Sección de Nefrología Pediátrica, Hospital Donostia, San Sebastián.

Nefrologia : Publicacion Oficial De La Sociedad Espanola Nefrologia
|June 29, 2004
PubMed

Insights

Severe primary reflux in infants often resolves spontaneously, favoring conservative management. While urinary infections can occur, long-term renal damage and failure are rare, particularly with prompt treatment.

Area of Science:

  • Pediatric Nephrology
  • Urology

Background:

  • Severe primary renal reflux is a significant concern in infants.
  • Understanding its clinical characteristics and natural evolution is crucial for effective management.

Purpose of the Study:

  • To analyze the clinical characteristics and evolution of severe primary renal reflux in infants.
  • To evaluate treatment outcomes and identify risk factors.

Main Methods:

  • Retrospective study of 203 infants diagnosed with severe primary renal reflux.
  • Utilized renal ecography, cyclic mictional cystography, and DMSA scans for diagnosis and assessment.
  • Analyzed treatment approaches (conservative vs. surgical) and patient outcomes.

Main Results:

  • Reflux was predominantly bilateral (77%) and of high grade (IV-V).
  • Renal injuries were associated with male infants and higher reflux grades.
  • Both conservative (79%) and surgical (21%) treatments showed high recovery rates (94.2% and 100%, respectively).
  • Long-term complications like chronic renal failure and hypertension were not observed.

Conclusions:

  • Severe primary reflux in infants is often bilateral, affects males, and can be linked to congenital renal dysplasia.
  • Spontaneous recovery is common, supporting a conservative treatment approach.
  • While urinary infections may occur, progression of renal injury is infrequent, and severe long-term outcomes are rare.
Abstract

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