Gender and vesico-ureteral reflux: a multivariate analysis

Area of Science:

• Pediatric Nephrology
• Urology
• Epidemiology

Background:

• Primary vesico-ureteral reflux (VUR) is a common congenital anomaly in children.
• Understanding gender-specific differences in VUR presentation and outcomes is crucial for effective management.

Purpose of the Study:

• To characterize patients with primary VUR, focusing on gender-specific differences.
• To identify factors associated with VUR presentation and clinical outcomes in relation to gender.

Main Methods:

• Retrospective cohort study of 735 patients diagnosed with VUR between 1970 and 2004.
• Analysis of variables including race, age, VUR grade, renal damage, and clinical presentation.
• Statistical methods included chi-square tests, logistic regression, and survival analysis to assess gender-specific differences and outcomes.

Main Results:

• Boys were more likely to present with non-white race, moderate/severe VUR, severe renal damage, diagnosis before 24 months, and antenatal presentation.
• Girls had a significantly higher risk of urinary tract infections (UTIs) during follow-up.
• No significant difference in progression to chronic renal insufficiency (CRI) was observed between genders.

Conclusions:

• Gender alone is a poor predictor of primary VUR clinical outcome.
• While boys exhibit a more severe initial VUR pattern, girls face increased risks of recurrent UTIs and dysfunctional voiding.
• Tailored management strategies considering gender-specific risks may improve outcomes in pediatric VUR.