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Rationale and design issues of the Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR) study

Ron Keren1, Myra A Carpenter, Alejandro Hoberman

  • 1Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA. keren@email.chop.edu

Pediatrics
|December 17, 2008
PubMed

Insights

This study investigated if trimethoprim/sulfamethoxazole prevents recurrent urinary tract infections and kidney scarring in children with vesicoureteral reflux. Findings will guide antibiotic prophylaxis decisions for pediatric patients.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Clinical Trials

Background:

  • Recurrent urinary tract infections (UTIs) and renal scarring are significant concerns in children with vesicoureteral reflux (VUR).
  • The efficacy of prophylactic antibiotics in preventing these outcomes remains a critical clinical question.

Purpose of the Study:

  • To determine if daily trimethoprim/sulfamethoxazole prophylaxis prevents recurrent UTIs and renal scarring in children with VUR.
  • To evaluate the risks and benefits of antibiotic prophylaxis in this pediatric population.

Main Methods:

  • The Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR) study is a double-blind, randomized, placebo-controlled trial.
  • 600 children aged 2-72 months with grades I-IV VUR were randomized to receive trimethoprim/sulfamethoxazole or placebo for 2 years.
  • Data collection included regular follow-up visits, telephone interviews, and biospecimen collection for future genetic and biochemical analyses.

Main Results:

  • The primary outcome measured was the recurrence of urinary tract infection.
  • Secondary outcomes included time to recurrent UTI, incidence of renal scarring, treatment failure, renal function, and antimicrobial resistance.

Conclusions:

  • The RIVUR study provides crucial data for clinicians regarding the use of prophylactic antibiotics in children diagnosed with VUR.
  • Findings will inform treatment decisions for preventing recurrent UTIs and their long-term renal sequelae in children.
Abstract

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