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[Evaluation of vesico-ureteral reflux in infants under 6 months of age]
J L Rodríguez Cimadevilla1, A Navarro Peñalver, A L Martínez Jiménez
1Hospital del Niño Jesús, Madrid.
Insights
Vesicoureteral reflux in infants under 6 months often has a good prognosis with medical treatment alone. Early recognition is crucial, even with negative urine cultures.
Area of Science:
- Pediatrics
- Nephrology
- Urology
Background:
- Vesicoureteral reflux (VUR) is a common condition in infants.
- Accurate diagnosis and prognosis are essential for appropriate management.
- Medical treatment is a primary approach for VUR in young infants.
Purpose of the Study:
- To evaluate the prognosis of VUR in infants under 6 months treated medically.
- To assess the role of clinical symptoms and urine cultures in diagnosis.
- To determine the long-term kidney status after medical management of VUR.
Main Methods:
- Retrospective evaluation of 45 infants under 6 months with VUR.
- All infants received medical treatment.
- Follow-up included echographic assessment of kidney status after a mean of 31.5 months.
Main Results:
- Bilateral VUR was present in 55.6% of infants, predominantly grade II (70%).
- Clinical symptoms were non-specific; 31.12% had negative urine cultures.
- Excellent kidney growth was observed, with no new renal lesions identified.
Conclusions:
- Infants under 6 months with VUR managed medically show a favorable prognosis.
- Medical management alone can lead to good long-term kidney outcomes.
- VUR should be considered in infants presenting with non-specific symptoms, regardless of urine culture results.
Abstract:
Forty-five infants less than 6 months old with vesicoureteral reflux have been evaluated in the Neonatology Unit of Niño Jesus Hospital. All of them have received medical treatment. We found bilateral vesicoureteral reflux in 55.6%, predominantly degree II (70%). Clinical symptoms were not specific, but it was evident that urine cultures were negative in 31.12%. After a mean follow-up of 31.5 months, kidney status was evaluated with echographic procedures. We found good growth in all but one case which was initially hypoplastic. New lesions were not demonstrated in the kidneys. We report a good prognosis for vesicoureteral reflux in infants of less than 6 months of age that have received only medical treatments. Therefore, we emphasize the importance of recognizing this pathology in infants, including those with negative urine cultures.