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Relationship among vesicoureteral reflux, urinary tract infection and renal damage in children

Svante Swerkersson1, Ulf Jodal, Rune Sixt

  • 1Department of Pediatrics, Pediatric Uro-Nephrologic Center, Göteborg University, Göteborg, Sweden. svante.swerkersson@vgregion.se

The Journal of Urology
|June 19, 2007
PubMed

Insights

Vesicoureteral reflux (VUR) is linked to permanent kidney damage in children. While VUR is a key factor in boys, urinary tract infections and inflammation play a larger role in girls.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Diagnostic Imaging

Background:

  • Urinary tract infections (UTIs) are common in infants.
  • Vesicoureteral reflux (VUR) is a significant risk factor for renal scarring.
  • Early identification of risk factors for renal damage is crucial.

Purpose of the Study:

  • To investigate the relationship between VUR, UTI, and permanent renal damage in young children.
  • To determine the influence of VUR grade and UTI characteristics on renal damage.
  • To differentiate etiological factors for renal damage in boys and girls.

Main Methods:

  • Retrospective analysis of 303 children under 2 years with first-time UTIs.
  • Utilized ultrasonography, voiding cystourethrography, and dimercaptosuccinic acid scintigraphy.
  • Assessed renal damage via scintigraphy 1-2 years post-UTI.

Main Results:

  • VUR identified in 22% of boys and 31% of girls.
  • Permanent renal damage observed in 26% of patients.
  • Higher VUR grade (II+) significantly increased renal damage risk.
  • C-reactive protein, fever, VUR, and recurrent UTIs correlated with renal damage.

Conclusions:

  • Grade II+ VUR is associated with permanent renal damage in both sexes.
  • Renal damage in boys is strongly linked to VUR, suggesting congenital origins.
  • In girls, UTI and inflammation appear equally or more critical than VUR for renal damage.
Abstract

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