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Primary vesicoureteral reflux in Iranian children
Fateme Ghane Sharbaf1, Mohamad Hosein Fallahzadeh, Ali Reza Modarresi
1Department of Pediatrics, Dr. Sheikh Hospital, Mashhad University of Medical Science, Iran.
Insights
Symptomatic primary vesicoureteral reflux (VUR) is more common in girls and has a better prognosis. Recurrence of urinary tract infections (UTI) in VUR patients was not dependent on the reflux grade.
Area of Science:
- Pediatric Nephrology
- Urology
- Medical Research
Background:
- Vesicoureteral reflux (VUR) management varies across centers, leading to ongoing controversies.
- Understanding VUR outcomes is crucial for effective patient care.
Purpose of the Study:
- To assess the outcomes of primary VUR complications.
- To determine the recurrence rate of urinary tract infections (UTI) in children with VUR.
Main Methods:
- Retrospective review of medical charts for 330 infants and children diagnosed with primary VUR between 1985 and 2004.
- Longitudinal follow-up by two pediatric nephrologists over a mean period of 4.5 years.
Main Results:
- Urinary tract infection (UTI) presented in 95% of cases; fever in 35%.
- VUR grades I-V showed similar UTI recurrence rates (17.9%-23.4%).
- Chronic renal failure and hypertension were observed in 13 patients each; renal scarring was more prevalent in boys (52%) than girls (29%).
Conclusions:
- Symptomatic primary VUR is more frequent and has a better prognosis in female patients.
- UTI recurrence in VUR is independent of the reflux grade.
Background:
Experience with vesicoureteral reflux (VUR) differs in different centers and there are plenty of controversies.
Objective:
The aim of this study was to evaluate the outcome of primary VUR complications and the rate of recurrence of UTI.
Methods:
The medical charts of all infants and children with primary VUR who were followed up by two nephrologist were reviewed. During 19 years (1985 to 2004), 330 patients (271 females, 59 males) with 496 refluxing ureters were followed up as primary VUR.
Results:
The patients age at diagnosis was 54 days to 16 years (Mean: 4.1 years) and the mean duration of follow-up was 4.5 years. Urinary tract infection (UTI) was the presenting symptom in 95% and fever was recorded in 35% of cases. Frequencies of different grades of VUR at initial investigation were 10% 35% 30% 13% and 12% for grades I to V, respectively. Recurrence of UTI in VUR of grades I to V, were 22.2% 18.1% 20% 23.4% and 17.9% respectively. Follow-up voiding cystourethrogram revealed resolution of VUR in 55% improvement in 27.5%, no change in 12% and deterioration in 5.5% Complications such as chronic renal failure and hypertension were observed in 13 and 13 patients, respectively. Renal scarring was present in 52% of boys and 29% of girls.
Conclusion:
The present study indicates that symptomatic primary VUR is more common and has better prognosis in girls. Recurrence of UTI is not related to the grade of VUR.
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