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Vesicoureteric reflux in children.

Jameela A Kari1, Sherif M El-Desoky, Faten Basnawi

  • 1Department of Pediatrics, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.

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|December 7, 2013
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Summary

Children with primary vesicoureteric reflux (VUR) and normal bladders maintain good kidney function. Secondary VUR, linked to bladder issues like posterior urethral valves or spina bifida, often results in impaired kidney function.

Keywords:
Childrenneurogenic bladderposterior urethral valvesprimary refluxsecondary refluxvesicoureteric reflux

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Area of Science:

  • Pediatric Nephrology
  • Urology
  • Medical Imaging

Background:

  • Vesicoureteric reflux (VUR) is a common condition in children.
  • Understanding the differences between primary and secondary VUR is crucial for management.
  • Associated bladder abnormalities can significantly impact kidney health.

Purpose of the Study:

  • To differentiate between primary and secondary VUR in children.
  • To assess the impact of bladder abnormalities on kidney function in VUR patients.
  • To evaluate the utility of dimercaptosuccinic acid (DMSA) scans in VUR assessment.

Main Methods:

  • Retrospective review of medical records of 99 children with VUR.
  • Analysis of radiological investigations and kidney function tests (creatinine levels).
  • Statistical analysis using Chi-square and paired t-tests.

Main Results:

  • Primary VUR (20.2%) showed normal kidney function; high-grade VUR was associated with renal scars (72%).
  • Secondary VUR (79.8%) stemmed from posterior urethral valves (PUV), neurogenic bladder (meningomyelocele, non-neurogenic neurogenic bladder [NNB]), or prune belly syndrome.
  • Children with secondary VUR and bladder abnormalities (NNB, meningomyelocele, PUV) presented with higher creatinine, but kidney function did not significantly worsen.

Conclusions:

  • Primary VUR with a normal bladder is linked to good kidney function.
  • Secondary VUR associated with bladder abnormalities (NNB, spina bifida, PUV) correlates with impaired kidney function.
  • DMSA scans effectively predict high-grade primary VUR.