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Height and weight in children with vesicoureteric reflux and renal scarring
C Polito1, A La Manna, A Capacchione
1Department of Pediatrics, Second University of Naples, Italy.
Insights
Children with bilateral vesicoureteric reflux and renal scarring show reduced height standard deviation scores (HSDS) and weight-for-height index (WHI). Other VUR types did not significantly impact growth compared to healthy controls.
Area of Science:
- Pediatric Nephrology
- Growth and Development
Background:
- Vesicoureteric reflux (VUR) is a common condition in children.
- Renal scarring can result from VUR and may impact long-term health.
- Growth parameters like height and weight are important indicators of child health.
Purpose of the Study:
- To evaluate height standard deviation scores (HSDS) and weight-for-height index (WHI) in children with VUR.
- To compare growth parameters in children with different types of VUR and renal scarring against healthy controls.
Main Methods:
- Retrospective analysis of 156 children with VUR and normal creatinine clearance.
- Comparison with 156 age- and sex-matched healthy controls.
- Categorization of VUR patients into groups based on laterality and presence of renal scarring.
Main Results:
- Children with bilateral VUR and renal scarring (B SCAR+) exhibited significantly lower HSDS and WHI compared to controls.
- 14% of B SCAR+ patients had height below -2 HSDS.
- Children with other VUR classifications (B SCAR-, U SCAR+, U SCAR-) showed growth parameters similar to controls.
Conclusions:
- Bilateral VUR with renal scarring is associated with impaired height growth in children.
- VUR without renal scarring or unilateral VUR does not appear to significantly affect growth parameters.
- Height and weight-for-height index are significantly correlated in children with VUR.
Abstract:
Height standard deviation scores (HSDS) and weight-for-height index (WHI) at diagnosis were evaluated in 156 children aged 2 months to 10.8 years (mean 3.7 years) with vesicoureteric reflux (VUR) and normal creatinine clearance, and in 156 age- and sex-matched healthy controls. Forty-three patients had bilateral VUR with scintigraphic signs of renal scarring (B SCAR+), 25 had bilateral VUR without renal scarring (B SCAR-); 40 had unilateral VUR with (U SCAR+) and 48 unilateral VUR without (U SCAR-) renal scarring. B SCAR+ patients had an average HSDS of -0.5 +/- 1.4 (SD) which was significantly (P = 0.02) below that of controls (0.05 +/- 1 HSDS) and an average WHI of 100.6% +/- 16% which was significantly (P = 0.007) below that of controls (108% +/- 12%); 14% of B SCAR+ patients had a height below -2 HSDS. B SCAR-, U SCAR+, and U SCAR- patients had heights near to O HSDS which was not different from that of controls, as well as WHI between 104% and 107.9%, which was not different from that of controls. HSDS and WHI were significantly (P = 0.00001) correlated in patients but not in controls. B SCAR-, U SCAR+, and U SCAR- patients are similar to healthy controls in weight and in height growth and have, on average, some excess weight as do the latter. In contrast, B SCAR+ subjects have a significant decrease of the relative height and normal WHI.