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A scoring system for predicting downgrading and resolution of high-grade infant vesicoureteral reflux

Sofia Sjöström1,2,3, Aldina Pivodic4,5, Kate Abrahamsson1,2

  • 1The Paediatric Uronephrologic Center, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|June 9, 2020
PubMed

Insights

A new scoring system helps predict resolution of high-grade infantile vesicoureteral reflux (VUR). High scores at one year indicate a low chance of VUR resolution, aiding clinical management.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Medical Diagnostics

Background:

  • Infantile high-grade vesicoureteral reflux (VUR) requires accurate prediction of resolution for effective management.
  • Identifying risk factors for persistent VUR is crucial for clinical decision-making.

Purpose of the Study:

  • To develop and validate a scoring system for predicting the downgrading and spontaneous resolution of high-grade infantile VUR (grades 4-5).

Main Methods:

  • Prospective study of 89 infants with high-grade VUR, followed to 39 months.
  • Analysis of risk variables including sex, breakthrough urinary tract infections (UTIs), renal damage, and glomerular filtration rate at one year.
  • Univariable and multivariable logistic regression used to identify independent predictors of VUR resolution.

Main Results:

  • A 14-point scoring system was developed using four independent risk factors.
  • Children with persistent VUR had significantly higher scores (mean 7.9) than those with spontaneous resolution (mean 4.5).
  • A score of ≥8 points predicted a low probability (≤14%) of VUR resolution, with an excellent area under the ROC curve (0.82).

Conclusions:

  • The developed scoring system is a practical tool for managing infants with high-grade VUR.
  • High scores at one year of age are indicative of a high risk for persistent, dilated reflux.
Abstract

Keywords:
high-gradeinfantsresolution and downgradingscoring systemvesicoureteral reflux

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