Independent risk factors for renal damage in a series of primary vesicoureteral reflux: A multivariate analysis

Silva, Jose Maria P.; Diniz, José Silvério Santos; Lima, Eleonora Moreira; Pinheiro, Sérgio Veloso Brant; Marino, V.; Cardoso, Luis Sérgio Bahia; Colosimo, Enrico A.; Silva, Ana Cristina Simões e; Oliveira, Eduardo A.

doi:10.1111/j.1440-1797.2008.01046.x

Cited by 20 publications

(10 citation statements)

References 36 publications

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“…Ongoing renal scarring is less common with proper disease recognition and treatment. However, studies report a more significant risk of renal scarring in higher grades of reflux [25,26]. With scarring comes the risk for hypertension, proteinuria, and reflux nephropathy with loss of renal function [27].…”

Section: Discussionmentioning

confidence: 98%

“…We chose patients with grades III-V VUR as these children have been shown to have a higher incidence of new scarring. These children have a higher risk group of recurrent UTIs, which would have a greater impact on QOL over patients with grades I and II VUR [21], who are more likely to have spontaneous resolution of the VUR than those with higher grades [22].…”

Section: Methodsmentioning

confidence: 98%

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Quality of life in children with vesicoureteral reflux

et al. 2011

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Vesicoureteral reflux (VUR) is commonly diagnosed in children presenting with urinary tract infections. Antibiotic prophylaxis and ureteric surgery are standard treatments for these children. Our aim was to investigate whether health-related quality of life (HRQOL) was altered in children treated for VUR. Children aged 1-5 years with grade III or higher VUR were identified through electronic records at the Stollery Children's Hospital. Parents of these children were mailed the TNO-AZL Netherlands Organisation for Applied Scientific Research Academic Medical Centre Quality of Life (TAPQOL) questionnaire. QOL scores for this group were compared with normative controls from the instrument's creators using the Mann-Whitney U test. Thirty-two of the 96 (33%) mailed surveys were returned. Eight children had surgery, and 19 were treated with antibiotic prophylaxis. When comparing the VUR group with the control group, we found that anxiety and social functioning scores were significantly better in patients with VUR (p < 0.01). The VUR group had worse scores in problem behavior, stomach complaints ,and communication (p < 0.01). This study reveals that children with VUR have a reasonable QOL when compared with controls. However, the diagnosis of VUR and its management does have an impact on gastrointestinal complaints, behavior, and communication, which may occur as a result of chronic medical intervention.

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Section: Discussionmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 98%

Quality of life in children with vesicoureteral reflux

et al. 2011

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“…The authors showed that the lowest risk of renal scarring after first episode of febrile urinary tract infection was in children in the first year of life and the highest one -in children aged 5 -14 years. It was also demonstrated that the male gender is an independent risk factor for renal scarring (Silva et al, 2009;Mohanan et al, 2008). The risk of post-inflammatory nephropathy development increases with the number of acute pyelonephritis episodes.…”

Section: Introductionmentioning

confidence: 98%

Post-Inflammatory Nephropathy

Bieniaś¹,

Zajączkowska²,

Borzęcka³

et al. 2011

Urinary Tract Infections

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“…Some studies have shown that up to 30% of children requiring renal replacement therapy for end-stage kidney disease had reflux nephropathy [5][6][7][8]. Therefore, acquired scarring associated with VUR from UTIs needs to be differentiated from primary congenital kidney damage from abnormal metanephric development [9] or from obstructive nephropathy [10]. Although the VUR is an established condition of risk for renal scarring after UTI, even infants with a normal urinary tract may be at risk of scarring [11].…”

Section: Introductionmentioning

confidence: 98%

Genetic susceptibility to renal scar formation after urinary tract infection: a systematic review and meta-analysis of candidate gene polymorphisms

et al. 2011

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Identifying patients who may develop renal scarring after urinary tract infections (UTI) remains challenging, as clinical determinants explain only a portion of individual risk. An additional factor that likely affects risk is individual genetic variability. We searched for peer-reviewed articles from 1980 to December 2009 in electronic databases that reported results showing an association between gene polymorphims and renal scaring after UTI. Two independent researchers screened articles using predetermined criteria. Studies were assessed for methodological quality using an aggregate scoring system. The 18 studies ultimately included in the review had investigated 16 polymorphisms in nine genes in association with renal scarring formation after UTI. Based on the predetermined criteria for assessing the quality of the studies, 12 studies (67%) were identified as being of poor quality design. A meta-analysis of cumulative studies showed on association between renal scarring formation after UTI and the angiotensin converting enzyme insertion/deletion polymorphism [ACE I/D; recessive model for D allele; odds ratio (OR) 1.73, 95% confidence interval (CI) 1.09-2.74, P = 0.02] or transforming growth factor (TGF)-β1 c.-509 T > C polymorphism (dominant model for T allele; OR 2.24, 95% CI 1.34-3.76, P = 0.002). However, heterogeneity among studies was large, indicating a strong difference that cannot only be explained by differences in study design. The studies reviewed in this article support a modest involvement of the vasomotor and inflammatory genes in the development of renal scarring after UTIs. This review also shows that only few possible candidate genes have been investigated for an association with renal scarring, raising the hypothesis that some gene polymorphisms may exert their effects through an interaction with as yet uninvestigated factors that may be related to geographic and/or socio-economic differences.

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Independent risk factors for renal damage in a series of primary vesicoureteral reflux: A multivariate analysis

Abstract: Our findings suggest that the development of a contracted renal unit is probably due to congenital malformation, more commonly observed in male infants with high-grade reflux.

Cited by 20 publications

References 36 publications

Quality of life in children with vesicoureteral reflux

Quality of life in children with vesicoureteral reflux

Post-Inflammatory Nephropathy

Genetic susceptibility to renal scar formation after urinary tract infection: a systematic review and meta-analysis of candidate gene polymorphisms

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