Evaluation of kidney growth in vesico-ureteral reflux

The parenchymal growth of 80 kidneys with vesicoureteral reflux (VUR), 50 of them surgically corrected, has been evaluated by calculating the ratio between bipolar thickness (BT) and the kidney length (KL), as measured radiographically. We consider this ratio provides a more precise evaluation of the morphologic and functional state of the refluxing kidney as it corresponded closely with the planimetric measurement of the area of renal parenchyma (ARP) in the 12 kidneys where this has also been calculated. Eighteen out of 30 medically treated refluxing kidneys showed a BT/KL ratio inferior to the 2 SD value for age at the time of diagnosis. A worsening BT/KL ratio has been observed in 6 out of 30 kidneys in which reflux ceased spontaneously and in 11 out of 50 which have been corrected surgically. The unfavourable outcome, as far as this parameter is concerned, in the medically treated cases seems to be due to the recurrence of urinary tract infection (UTI); while there is non so clear explanation for it in cases which have been surgically corrected.