Long-term clinical follow up of children with primary vesicoureteric reflux

Area of Science:

• Pediatric Nephrology
• Urology

Background:

• Primary Vesicoureteric reflux (VUR) in children often follows urinary tract infections (UTIs).
• Long-term outcomes and management strategies for pediatric VUR require ongoing investigation.

Purpose of the Study:

• To prospectively evaluate long-term outcomes in children with primary VUR.
• To assess the efficacy and safety of low-dose prophylactic antibiotics in managing VUR and preventing renal damage.

Main Methods:

• Prospective study of 56 children (under 12 years) with primary VUR for 6-12 years.
• Voiding cystourethrogram for VUR detection, DMSA scans for renal scarring, and monitoring for breakthrough infections and renal failure.
• Treatment involved low-dose prophylactic antibiotics until age 5, with regular monitoring.

Main Results:

• 55.3% had detectable renal scars; 17.9% experienced breakthrough UTIs on prophylaxis.
• No major adverse effects from antibiotics; no clinical or laboratory evidence of renal failure observed.
• Conservative management with prophylactic antibiotics was successful in the majority of cases.

Conclusions:

• Low-dose prophylactic antibiotic therapy is a safe and effective conservative management strategy for pediatric VUR.
• Long-term monitoring can prevent significant renal damage and failure in most children with VUR.
• Conservative management is a viable alternative to surgical intervention for many VUR cases.