Clinical Course and Effective Factors of Primary Vesicoureteral Reflux

Area of Science:

• Pediatric Nephrology
• Urology
• Clinical Medicine

Background:

• Vesicoureteral reflux (VUR) is a primary cause of urinary tract infections and potential renal failure in pediatric populations.
• VUR can be a self-limiting condition, necessitating an understanding of its natural clinical progression.
• Identifying factors influencing VUR resolution and associated renal damage is crucial for effective management.

Purpose of the Study:

• To retrospectively analyze the clinical course of primary VUR in a cohort of infants and children.
• To identify significant factors associated with spontaneous resolution of VUR.
• To evaluate the incidence and predictors of renal damage and reflux nephropathy in children with VUR.

Main Methods:

• Retrospective review of medical charts for 125 infants and children diagnosed with primary VUR (all grades).
• Data collected included patient demographics, VUR grade and laterality, renal function (DMSA scan), and history of recurrent urinary tract infections.
• Statistical analysis to determine correlations between clinical factors and VUR resolution, renal damage, and reflux nephropathy.

Main Results:

• Over half (53.6%) of patients experienced spontaneous resolution of VUR.
• Decreased renal function was observed in 30.1% of patients, notably higher in males and those with severe VUR.
• Reflux nephropathy occurred in 17.6% of cases, particularly associated with pre-existing renal damage and male gender.

Conclusions:

• Spontaneous VUR resolution is significantly associated with female gender, diagnosis at age ≤30 months, mild-to-moderate VUR, unilateral reflux, and absence of renal damage.
• Recurrent urinary tract infections did not show a significant association with VUR severity or initial renal damage.
• Early diagnosis and identification of favorable prognostic factors can aid in managing VUR and preventing long-term renal sequelae in children.