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Evaluation of Renal Function and Scars in Children With Primary Vesicoureteral Reflux
Alessia Marcellino1, Silvia Bloise1, Roberta Fraternali1
1Pediatrics and Neonatology Unit, Maternal-Child Department, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy.
Insights
This study on primary VUR in children found stable renal function over time. However, identifying congenital renal damage is crucial for long-term outcomes in pediatric patients.
Area of Science:
- Pediatric Nephrology
- Urology
Background:
- Primary Vesicoureteral Reflux (VUR) is a common condition in children.
- Early detection and management are essential to prevent renal damage.
Purpose of the Study:
- To evaluate growth, renal function, and damage in children with primary VUR.
- To assess the long-term impact of VUR on kidney health.
Main Methods:
- Retrospective analysis of clinical records from January 2006 to September 2020.
- Evaluation of growth, laboratory tests, scintigraphy, and urodynamics.
- Inclusion of 41 children with primary VUR on antibiotic prophylaxis.
Main Results:
- Glomerular function and urodynamics remained stable over time.
- Female sex was linked to nephrolithiasis and proteinuria.
- Proteinuria increased with age, while the protein-to-creatinine ratio decreased.
Conclusions:
- Renal function is generally stable in children with primary VUR.
- Identifying significant congenital renal damage is critical for managing these patients.
Objective:
To evaluate growth, glomerular and tubular function, renal damage, scars in children affected by primary VUR.
Methods:
We retrospectively evaluated the clinical records of our Unit from January 2006 to September 2020. For each patient we evaluated growth, laboratoristic and scintigraphic glomerular and tubular function, renal damage and collective system urodynamics at baseline and at the last visit.
Results:
We enrolled 41 patients affected by primary VUR and treated with continuous antibiotic prophylaxis. Glomerular function and urodynamics did not change over time. EFNa directly correlated with weight (r 0.44 P .004) and TRP inversely correlated with severity of reflux (r -0.32, P .04). Female sex was associated to nephrolithiasis (OR 17.0, P .02) and proteinuria (at T0 OR 5.8 P .03 at T1 OR 5.8, P .03). Daily proteinuria increased with age (r 0.66, P <.0001 at T0 and r 0.44 P .004 at T1) while protein-to-creatinine ratio decreased. Renal scars at T0 inversely correlated with glomerular and tubular function at T1 but they did not correlate with severity or laterality of reflux.
Conclusion:
Even if renal function remains stable through years, it is critical to identify the subjects with significant congenital renal damage.
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