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Predicting long-term renal damage in children with vesicoureteral reflux under conservative initial management: 205

Natalia Alvarez1, Reyes Delgado Alvira2, Yurema Gonzalez Ruiz2

  • 1Universidad Autonoma De Barcelona, Parc Tauli, Pediatric Surgery, Sabadell, Spain.

Central European Journal of Urology
|May 8, 2018
PubMed

Insights

Conservative management is effective for most children with primary vesicoureteral reflux (VUR), leading to good outcomes. However, high-grade VUR and initial renal damage increase the risk of complications and surgery.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Pediatric Surgery

Background:

  • Vesicoureteral reflux (VUR) is a common pediatric condition.
  • Guidelines suggest conservative management for VUR, escalating to surgery for breakthrough febrile urinary tract infections (UTIs).
  • VUR management remains a topic of debate.

Purpose of the Study:

  • To evaluate the efficacy of conservative treatment for primary VUR in children.
  • To assess the impact of conservative management on renal function and scarring.
  • To identify prognostic factors for adverse outcomes in children with primary VUR.

Main Methods:

  • Retrospective study of 205 children with primary VUR treated conservatively (1989-2015).
  • Data included demographics, diagnosis, ultrasound, DMSA scans, and VCUG.
  • Statistical analysis performed using SPSS.

Main Results:

  • 40.89% of patients had renal damage at diagnosis.
  • 15.12% experienced renal scarring or decreased kidney function during follow-up.
  • High-grade VUR and initial renal damage were associated with increased risk of surgery and poorer renal function, respectively.

Conclusions:

  • Conservative strategy is a viable and effective treatment for most children with primary VUR.
  • Long-term follow-up shows good outcomes with conservative management.
  • High-grade VUR and renal damage at diagnosis are risk factors for surgical intervention and impaired renal function.
Abstract

Keywords:
childrenevidence-based practicerenal insufficiencyurinary tract infectionvesicoureteral reflux

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