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Evaluating kidney damage from vesico-ureteral reflux in children
M Zaffanello1, M Franchini, M Brugnara
1Department of Mother-Child and Biology-Genetics, University of Verona, Italy. marco.zaffanello@univr.it
Summary
Children with severe primary vesico-ureteral reflux (VUR) face a significantly higher risk of kidney damage, even from prenatal stages. Early intervention is key to preventing congenital kidney damage in these cases.
Area of Science:
- Pediatric Nephrology
- Urology
- Clinical Research Methodology
Background:
- Primary vesico-ureteral reflux (VUR) is a common condition in children.
- Kidney damage is a significant complication associated with VUR.
- Early diagnosis and intervention are crucial for managing VUR and preventing renal sequelae.
Purpose of the Study:
- To review clinical studies evaluating kidney damage in children with primary VUR.
- To compare the risk of kidney damage in children with VUR versus controls.
- To identify factors influencing the progression of kidney damage in VUR.
Main Methods:
- Systematic review and comparison of randomized controlled trials and clinical trials.
- Diagnosis of VUR confirmed by voiding cystourethrogram.
- Assessment of kidney damage using DMSA scan or urography.
- Statistical analysis of relative risk using Review Manager Software.
Main Results:
- Children with VUR showed a statistically higher relative risk of kidney damage (3.7 times by DMSA, 2.8 times by urography) compared to controls.
- High-grade VUR was associated with a 5.6 times higher relative risk of congenital kidney damage.
- Kidney damage in VUR may have a prenatal onset and progress with untreated infections.
Conclusions:
- Severe VUR is strongly linked to early, potentially prenatal, kidney damage.
- The progression of kidney damage is influenced by VUR severity and untreated urinary tract infections.
- Early intervention, including during fetal development, can prevent congenital kidney damage in severe VUR cases.
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