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Plasma renin activity for monitoring vesicoureteric reflux therapy: mid-term observations

Minu Bajpai1, C S Bal, M Kalaivani

  • 1Department of Paediatric Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. bajpai2@hotmail.com

Journal of Pediatric Urology
|July 18, 2008
PubMed

Insights

Plasma renin activity (PRA) can help monitor vesicoureteric reflux (VUR) treatment. Serial PRA measurements may improve patient stratification and prognosis for moderate to high-grade VUR.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Biomarkers

Background:

  • Vesicoureteric reflux (VUR) can lead to renal scarring and dysfunction.
  • Current monitoring methods may not detect damage early enough.

Purpose of the Study:

  • To evaluate plasma renin activity (PRA) as an early marker for monitoring treatment of VUR.
  • To assess the utility of PRA in stratifying patients with VUR.

Main Methods:

  • Fifty-nine children with primary VUR (grades I-V) were enrolled.
  • PRA, renal scarring, split renal function (SRF), GFR, creatinine, blood pressure, and UTIs were monitored.
  • PRA values were analyzed post-hoc, comparing surgical and non-operative management.

Main Results:

  • A rise in PRA was observed pre-surgery in all patients.
  • PRA normalized post-surgery in 86% of cases.
  • Non-operative management showed a progressive rise in PRA in 80.9% of children, indicating ongoing damage.

Conclusions:

  • Non-operative management endpoints may be reached after irreversible renal damage has occurred.
  • Serial PRA measurements can aid in better patient stratification for moderate to high-grade VUR.
  • PRA may serve as a valuable prognostic indicator for VUR management.
Abstract

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