Pediatric Vesicoureteral Reflux Guidelines Panel Summary Report: Clinical Practice Guidelines for Screening Siblings of Children With Vesicoureteral Reflux and Neonates/Infants With Prenatal Hydronephrosis

Skoog, Steven J.; Peters, Craig A.; Arant, Billy S.; Copp, Hillary L.; Elder, Jack S.; Hudson, Rebekah; Khoury, Antoine E.; Lorenzo, Armando J.; Pohl, Hans G.; Shapiro, Ellen; Snodgrass, Warren; Diaz, Mireya

doi:10.1016/j.juro.2010.05.066

Cited by 195 publications

(120 citation statements)

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“…14 The prevalence of VUR determined from a recent meta-analysis was 27.4 (2.9-51.9) per 100 siblings screened and 35.7 (21.2-61.4) per 100 offspring screened. 13 Our study revealed that 45% of screened siblings without previous UTI have VUR. Similar, Noe et al investigated 354 siblings of 275 index patients and found 119 (34%) with VUR, including 75% asymptomatic siblings.…”

Section: Discussionmentioning

confidence: 59%

“…Children with VUR and UTI are nearly 4 times more likely to have a renal scar in refluxing units than those with pyelonephritis and no reflux. 13,16 Risk factors for renal functional abnormalities in siblings were associated with a history of a previous UTI, high-grade VUR, and age .1 year. Our study showed that the prevalence of renal damage in screened siblings without previous UTI was 15%, whereas it was 34% in siblings with a previous UTI.…”

Section: Discussionmentioning

confidence: 98%

“…12 Screening siblings of index patients with VUR has been proposed to detect a population at risk, potentially allowing treatment to prevent acute illness and decrease adverse outcomes associated with VUR, including UTIs, pyelonephritis, and renal injury. 13 However, screening of asymptomatic siblings and offspring of refluxing parents is controversial. 14 Although some clinicians believe that early identification of children with VUR may prevent episodes of UTIs and associated renal scarring, others think that screening asymptomatic individuals is likely to result in overtreatment of clinically insignificant VUR.…”

Section: Discussionmentioning

confidence: 99%

“…13,17 To establish guidelines, data from 22 articles published between 1975 and 2008, including 2957 siblings and 244 offspring, were analyzed. However, the lack of prospective studies for screened siblings to assess clinical health and outcomes made evidence-based guideline recommendation difficult.…”

Section: Discussionmentioning

confidence: 99%

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Renal Cortical Abnormalities in Siblings of Index Patients With Vesicoureteral Reflux

2014

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WHAT'S KNOWN ON THIS SUBJECT:The familial nature of vesicoureteral reflux (VUR) is well recognized. Several studies have shown that siblings of children with VUR are at much higher risk for reflux than the general pediatric population with a reported prevalence between 26% and 50%. WHAT THIS STUDY ADDS:There is increased risk of renal cortical abnormalities in siblings with a previous urinary tract infection, siblings with high-grade VUR, and siblings .1 year of age. This information may be useful when counseling parents about the risk of familial VUR. abstract OBJECTIVE: Screening siblings of index patients with vesicoureteral reflux (VUR) has been proposed to identify children who are at risk for renal damage. However, screening siblings for VUR remains controversial. We investigated the prevalence of VUR and renal cortical abnormalities in the sibling population in a large cohort of families with VUR.METHODS: Between 1998 and 2012, parents of index patients with grade III to V VUR were asked permission to screen siblings ,6 years of age for VUR. Siblings were divided into 2 groups: siblings with a documented history of a previous urinary tract infection (UTI) and siblings who were screened for VUR and never had a UTI. A logistic regression model was used to determine independent risk factors associated with renal cortical abnormalities such as history of presentation, age, gender, and grade of VUR.RESULTS: There were 318 siblings in 275 families in the study. VUR was found after screening in 190 (60%) siblings and after a UTI in 128 (40%). Multivariate analysis revealed that siblings who had a previous UTI (odds ratio: 3.38), siblings with high grade reflux (odds ratio: 3.62), and siblings over 1 year of age (odds ratio: 2.84) were the most significant independent risk factors associated with renal cortical abnormalities. CONCLUSIONS:There is increased risk of renal cortical abnormalities in siblings with a previous UTI, siblings with high-grade VUR, and siblings over age 1 year. This information may help to counsel parents about the risk of VUR and reflux nephropathy in familial VUR. Pediatrics 2014;133:e933-e937 AUTHORS:

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Renal Cortical Abnormalities in Siblings of Index Patients With Vesicoureteral Reflux

2014

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“…1 Most often VUR is an incidental finding in children with UTI, when screening is done for urological anomalies. The incidence of VUR has got geographical, racial and gender variation.…”

Section: Introductionmentioning

confidence: 99%