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Renal growth after antireflux surgery in infants
Insights
Children undergoing surgery for refluxing ureters showed good outcomes. Kidneys with less initial damage grew normally post-surgery, while those with significant damage had poorer growth.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Outcomes
Background:
- Vesicoureteric reflux (VUR) is a condition where urine flows backward from the bladder to the ureters.
- Surgical intervention is often necessary for VUR to prevent kidney damage and infections.
- Long-term kidney growth and function after VUR surgery in infants require further investigation.
Purpose of the Study:
- To evaluate long-term kidney growth in children following surgical correction of refluxing ureters.
- To assess the relationship between preoperative renal parenchymal area and postoperative kidney growth.
- To determine the success rate of surgery in eradicating vesicoureteric reflux.
Main Methods:
- Retrospective study of thirteen children (11 boys, 2 girls) who underwent surgery for VUR during infancy.
- Follow-up duration ranged from five to seven years postoperatively.
- Kidney growth was assessed by measuring renal parenchymal area using planimetry.
Main Results:
- 14 out of 15 ureters were free from reflux at follow-up, indicating high surgical success.
- Children with initially pronounced renal parenchymal reduction demonstrated poor kidney growth.
- Kidneys with smaller preoperative parenchymal reduction showed normal growth postoperatively.
Conclusions:
- Surgical correction of refluxing ureters in infancy can lead to successful reflux resolution.
- Preoperative kidney parenchymal status is a critical factor influencing long-term kidney growth after VUR surgery.
- Early detection and intervention for VUR are crucial to preserve kidney function and promote growth.
Abstract:
Thirteen children (eleven boys and two girls) with fifteen refluxing ureters have been operated upon during infancy and been followed between five and seven years postoperatively. Kidney growth has been studied by determining renal parenchymal area by planimetry. 14/15 were free from reflux at follow-up. Postoperative vesicoureteric obstruction was found in one infant. In the cases where the kidney had a pronounced parenchymal reduction at presentation poor kidney growth was demonstrated. However, the nine kidneys which had a smaller parenchymal reduction at presentation normal showed growth postoperatively.