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Antireflux surgery does not change ongoing renal functional deterioration

Seçil Arslansoyu Çamlar1, Sevinç Çağlar2, Alper Soylu1

  • 1a Division of Pediatric Nephrology, Department of Pediatrics , Dokuz Eylul University Faculty of Medicine , Izmir , Turkey ;

Renal Failure
|January 21, 2016
PubMed

Insights

Antireflux surgery for vesicoureteral reflux (VUR) in children with urinary tract infections (UTI) did not alter the progression of kidney damage. Renal function deterioration continued regardless of surgical intervention.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Medical Imaging

Background:

  • Vesicoureteral reflux (VUR) is a condition often associated with urinary tract infections (UTI) in children.
  • Treatment options include antimicrobial prophylaxis and antireflux surgery.
  • The impact of surgery on long-term renal function in VUR patients remains a critical question.

Purpose of the Study:

  • To investigate whether antireflux surgery influences the progression of renal functional deterioration in pediatric patients with VUR and a history of UTI.
  • To compare renal outcomes between medically managed and surgically treated VUR patients.

Main Methods:

  • Retrospective analysis of medical records for 140 children diagnosed with VUR during UTI evaluation.
  • Assessment of renal function using estimated glomerular filtration rate and urinary protein levels.
  • Comparison of renal scarring on ultrasonography (US) and 99mTc-dimercaptosuccinic acid (99mTc-DMSA) scintigraphy between medically and surgically treated groups.

Main Results:

  • Of 140 patients, 82 received medical treatment and 58 underwent antireflux surgery.
  • The antireflux surgery group showed higher rates of abnormal US, DMSA findings, and renal function impairment.
  • Progressive renal scarring was more prominent in the surgical group, despite similar recurrent UTI rates.

Conclusions:

  • Antireflux surgery does not halt or reverse ongoing renal injury in children with VUR.
  • Renal functional deterioration may continue irrespective of surgical intervention for VUR.
  • Bilateral renal scarring was a significant factor in progressive renal injury within the surgically treated group.
Abstract

Keywords:
Antireflux surgerychildrenrenal scarvesicoureteral reflux

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