Growth of the Kidney following Unilateral Antireflux Surgery

Physical Growth Velocity during Conservative Treatment and following Subsequent Surgical Treatment for Primary Vesicoureteric Reflux

“…Previous studies of the treatment of vesicoureteric reflux have shown that renal function can be maintained by both medical and surgical means (Birmingham Reflux Study Group, 1983, 1987Atwell, 1984, Scott el al., 1986. Renal growth has been shown to increase following surgery for vesicoureteric reflux (McRae et al, 1974;Atwell et al, 1978;Atwell and Cox, 1981;Ginalski et al, 1986), but no significant difference in renal growth has been observed following either medical or surgical treatment when compared in a controlled trial (Birmingham Reflux Study Group, 1983,1987. It is interesting to note, however, that in this trial there was a trend for the renal standard deviation scores to fall further during medical treatment than following surgical treatment.…”

“…Both the medical and surgical treatment of vesicoureteric reflux can prevent ascending urinary infection and the subsequent development or progression of renal scarring (McRae et al, 1974;Edwards et al, 1977;Atwell et al, 1978;Aladjem et al, 1980;Atwell and Cox, 1981;Ginalski et al, 1986). Recent evidence suggests that neither treatment fully protects the kidneys from further damage and that when patients with primary vesicoureteric reflux are allocated on a random basis to either treatment, neither appears preferable (Birmingham Reflux Study Group, 1983, 1987.…”

Effects of Vesicoureteric Reflux on Renal Growth and Function as Measured by GFR, Plasma Creatinine and Urinary Concentrating Ability: An Experimental Study in the Minipig

“…The mean age at operation was 3.4 years and the majority of renal length measurements both pre-and post-operatively were therefore obtained during a non-linear phase of renal growth. The results of Atwell and Cox (1981) in a study on postoperative renal growth suffer from similar problems. Their conclusions that observed mean growth was greater than the expected "normal" growth are affected by including kidneys from children as young as 1 month, and comparing the growth with the linear growth expected in older children.…”