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Renal scarring and vesicoureteric reflux
Archives of Disease in Childhood
|March 1, 1978
Summary
Urinary tract infections in children are often linked to severe vesicoureteric reflux (VUR), especially in infants. Early cystourethrography is crucial for diagnosing VUR and preventing kidney scarring.
Area of Science:
- Pediatric Nephrology
- Urology
Background:
- Urinary tract infections (UTIs) are common in children.
- Vesicoureteric reflux (VUR) is a significant risk factor for renal scarring.
Observation:
- A review of 105 children with UTIs revealed an increased prevalence of grades II-III VUR with decreasing age.
- Severe VUR was common in infants, affecting boys and girls equally.
- 98% of radiologically scarred kidneys were associated with refluxing ureters.
Findings:
- Renal scar prevalence significantly correlated with VUR severity.
- Deterioration or new formation of renal scars occurred in 15 children, predominantly with grade III VUR.
- New scars developed after age 5 in some children.
Implications:
- Cystourethrography is essential for all children with recurrent UTIs, regardless of age, to detect VUR.
- In children under 5, early cystourethrography is vital due to the high prevalence of severe VUR and renal scarring.
- Prompt diagnosis and management of VUR can prevent long-term kidney damage.