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Vesicoureteral Reflux in Children with Accidental Diagnosis of Unilateral Small Size Kidney

Mohsen Mohammadi1, Khadijeh Ebrahimi2, Soraya Khafri3

  • 1Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, I.R. Iran.

Urology Research & Practice
|January 28, 2025
PubMed

Insights

A majority of children with small kidneys were diagnosed with vesicoureteral reflux (VUR), a condition where urine flows backward. This suggests VUR may cause small kidneys, necessitating VUR evaluation in affected children.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Diagnostic Imaging

Background:

  • Small kidney size in children is often diagnosed after urinary tract infections (UTIs) and high-grade vesicoureteral reflux (VUR).
  • Accidental diagnosis of small kidneys by ultrasonography highlights the need for further investigation into underlying causes.

Purpose of the Study:

  • To investigate the prevalence of VUR and UTIs in children incidentally diagnosed with small kidneys.
  • To determine the potential etiological role of VUR in the development of small kidneys in pediatric patients.

Main Methods:

  • Longitudinal retrospective study of children diagnosed with small kidneys between 2012-2022.
  • Diagnostic workup included dimercapto succinic acid (DMSA) renoscintigraphy, voiding cystourethrography (VCUG) or radionuclide cystography (RNC) for VUR, and regular urinalysis/urine cultures for UTI.
  • Follow-up for at least 1 year to monitor for UTIs.

Main Results:

  • Out of 86 children, 32.6% were diagnosed with VUR, predominantly in boys (71.4% of VUR cases).
  • Children with VUR had a higher incidence of UTIs (42.9%) compared to those without VUR (10.3%).
  • Escherichia coli was the most common UTI pathogen (55.6%).

Conclusions:

  • Accidental diagnosis of small kidneys in children is frequently associated with VUR, particularly in boys.
  • VUR is a significant potential etiological factor in the development of small kidneys.
  • Routine evaluation for VUR is recommended for children diagnosed with small kidneys.
Abstract

Keywords:
Childrensmall-sized kidneyurinary tract infectionvesicoureteral reflux

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