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Prevalence of Vesicoureteral Reflux in Children with Urinary Tract Infection
Mitra Naseri1, Niayesh Tafazoli1, Nooshin Tafazoli1
1Department of Pediatric Nephrology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
Vesicoureteral reflux (VUR) affects nearly half of children with urinary tract infections (UTI), with prevalence decreasing with age. Early diagnosis is key, as VUR is more common in younger children and boys.
Area of Science:
- Pediatric Nephrology
- Urology
Background:
- Vesicoureteral reflux (VUR) is a common condition in children, often associated with urinary tract infections (UTIs).
- Understanding VUR prevalence across different age groups is crucial for timely diagnosis and management.
Purpose of the Study:
- To determine the frequency of VUR in children diagnosed with UTI.
- To analyze the changes in VUR prevalence from birth up to 18 years of age.
Main Methods:
- Observational retrospective study conducted between 2003-2016.
- Included 908 children (aged 3 days to 214 months) with UTI who underwent direct cystourethrography.
- Data analyzed for VUR presence, grade, age at diagnosis, and associated findings.
Main Results:
- Vesicoureteral reflux (VUR) was identified in 46.14% of children with UTI.
- VUR prevalence was highest in the first year of life (56.64%) and decreased with age, reaching 0% between 13-18 years.
- High-grade VUR and overall VUR were significantly more prevalent in boys. Patients with VUR were diagnosed at a younger age and had more abnormal kidney ultrasound findings.
Conclusions:
- Vesicoureteral reflux (VUR) is a significant finding in pediatric urinary tract infections (UTIs), particularly in infants.
- The prevalence of VUR decreases with age, highlighting the importance of early detection and intervention.
- Boys are more susceptible to high-grade VUR, and associated renal abnormalities warrant close monitoring.
Abstract:
Vesicoureteral reflux (VUR) is reported in 30%-50% of children affected by urinary tract infection (UTI). We aimed to investigate the frequency of VUR in children presenting with UTI and the changes in its prevalence from birth up to 18 years. This research was an observational retrospective study in the nephrology clinic of an academic tertiary hospital during 2003-2016. Patients with UTI subjected to direct cystourethrography were enrolled (908 patients, 86.23% of girls and 13.77% of boys). They were aged from 3 days to 214 months (33 ± 33.2 months). VUR was observed in 419 of 908 (46.14%) cases. High-grade VUR (VUR Grades IV-V) and VUR were significantly more prevalent in boys (P = 0.001 for both). Only 9.2% of the VUR subjects were diagnosed after 5 years of age. The patients with VUR developed UTI at a significantly younger age compared with those without VUR (P = 0.0001). Abnormal kidney ultrasound results were significantly more common in patients with VUR than in those without VUR (P = 0.0001). The prevalence of VUR in the 1st, 2nd, 3rd, 4th, and 5th years of life was estimated to be 56.64%, 48.2%, 49.46%, 35.8%, and 45.07%, respectively. The highest and lowest VUR prevalence was 56.64% (1st year of life) and 0% (13-18 years). In addition, severe VUR was not an uncommon finding, and affected 10.7% of the total population. The results indicated a decrease in the prevalence of VUR with increased age when considering the five main age subgroups of childhood.
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