Relationship Among Vesicoureteral Reflux, Urinary Tract Infection and Renal Damage in Children

Swerkersson, Svante; Jodal, Ulf; Sixt, Rune; Stokland, Eira; Hansson, Sverker

doi:10.1016/j.juro.2007.04.004

Cited by 135 publications

(94 citation statements)

References 21 publications

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“…(table IV) This figure is similar to the study done by Bhatnagar et al 11 in India where they found 62% children with UTI had VUR ( majority in grade V) but higher than the studies done by the other workers of different countries. 17,18,20,24 Zaki et al found the incidence of reflux 22%. 31 This difference may be due to that our country and India have more or less similar geographical, cultural and socioeconomic background and both the studies were done in tertiary level hospital and the patients reach there late due to parental ignorance, poverty and late referral by the primary and secondary care givers.…”

Section: Discussionmentioning

confidence: 99%

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Association of Vesicoureteric Reflux (VUR) in Children with Symptomatic Urinary Tract Infection (UTI) - in a Tertiary Care Hospital, Dhaka, Bangladesh

Begum

Rahman

Hossain

et al. 2013

Bangladesh J Child Health

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Section: Discussionmentioning

confidence: 99%

“…[18][19][20]21,22, The lowest prevalence is in black Americans 6%-12%. [2][3][4] Venhola et al conducted a large study on children with UTI in Finland recently and had shown that 36% of children with proven UTI , 28% with possible UTI and 36% with improbable UTI had associated VUR.…”

Section: Discussionmentioning

confidence: 99%

Association of Vesicoureteric Reflux (VUR) in Children with Symptomatic Urinary Tract Infection (UTI) - in a Tertiary Care Hospital, Dhaka, Bangladesh

Begum

Rahman

Hossain

et al. 2013

Bangladesh J Child Health

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“…UTIs were tabulated by severity, where possible, and the grade of VUR was recorded based on the initial cystogram. Sonographically determined renal length was tabulated for all ultrasounds obtained The relationship between urinary tract infections (UTIs), renal scarring, and vesicoureteral reflux (VUR) has been investigated in multiple studies over numerous decades [1][2][3][4][5]. Even though renal failure secondary to the interaction of VUR and UTI is decidedly rare, the relationship is of interest.…”

Section: Discussionmentioning

confidence: 99%

645 Sonographic Assessment of the Effect of Vesicoureteral Reflux and Urinary Tract Infections on Growth of the Pediatric Solitary Kidney

Ross¹,

Chen²,

Roelof³

et al. 2013

Journal of Urology

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SummaryIntroduction-Perusal of recent guidelines relating to proper evaluation of infants and children with urinary tract infection (UTI) suggests that the occurrence of vesicoureteral reflux (VUR) may not have the clinical import previously ascribed to this anatomic abnormality. Patients with a solitary kidney uniquely allow investigation of the effects of both vesicoureteral reflux (VUR) and urinary tract infection (UTI) on renal growth unencumbered with the inevitable questions of laterality that confound analysis in patients with two kidneys. Several previous studies with conflicting results have addressed whether vesicoureteral reflux (VUR) impacts ultimate renal size in children with a solitary kidney. Few published studies have considered the occurrence of both urinary tract infection (UTI) and VUR on the degree of compensatory hypertrophy. This is the largest series to date investigating the effect of both UTI and VUR on the degree of compensatory hypertrophy with time.

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“…Permanent renal damage has been reported to occur more often in patients with VUR of radiologic grade II or higher (16). Because scintigraphic pelvic reflux is equivalent to radiologic grade II or higher reflux, we included patients with scintigraphic pelvic reflux in this study.…”

Section: Discussionmentioning

confidence: 99%

New Quantitative Parameters for Evaluating Radionuclide Cystography and Their Value in Understanding the Physiology of Reflux

Özdoğan

Türkmen²,

Atasever³

et al. 2009

Journal of Nuclear Medicine Technology

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In this descriptive study of radionuclide cystography, timeactivity curves were generated from renal pelves with reflux and evaluated to reveal the physiology of the reflux. The generated new parameters were also evaluated for any correlation with the frequency of urinary tract infections and renal scarring. Methods: Thirty-two children with reflux to the renal pelvis (36 refluxing units) were included. Regions of interest were drawn on the pelves and bladder, and time-activity curves were generated. The first reflux phase, the bladder volume at first reflux, and the bladder volume at maximal reflux were defined, and reflux percentages were calculated. Dimercaptosuccinic acid (DMSA) scintigraphy findings and urinary tract infections were used for correlation. Results: New curves from the renal pelvis during bladder filling and bladder emptying were generated and their patterns classified. Episodic reflux to the pelvis was observed on time-activity curves, which demonstrated 4 different emptying patterns during voiding. These patterns were described in detail. Visually, residual activity was present in the renal pelves in 58.8% of patients. The mean number of urinary tract infections per year was 1.07 (range, 0-4; SD, 0.88). The DMSA findings were normal in 57.1% of the patients. Conclusion: We obtained and categorized some new time-activity curve patterns from renal pelves with reflux on radionuclide cystography. Discussing these patterns may help physicians understand the physiology of the reflux and the relationship between infections and reflux. Vesi coureteral reflux (VUR) is a predisposing factor for urinary tract infection (1), and up to 20%240% of patients with urinary tract infection have been shown to have reflux (2-4). The causes of renal scarring are multifactorial, and VUR has been declared to be one of the main risk factors (5). Early diagnosis of VUR and urinary tract infection is necessary to decrease renal scarring (3). VUR may result in hypertension and end-stage renal disease (3,6,7). The correlation between renal scarring and VUR has been shown to vary between 23% and 75% and is higher in patients with a high grade of VUR (8-11). The prevalence of renal damage is higher in patients with severe reflux (7,12,13). Therefore, children with high grades of VUR must be carefully managed, treated, and followed up to achieve a better outcome in adulthood (3).Radionuclide cystography, the preferred procedure for the follow-up of patients with VUR, allows continuous acquisitions and exposes patients to less radiation than does voiding cystourethrography (14).Some information that can be obtained from radionuclide cystography has been shown to correlate with prognosis. In one study, urinary bladder volume and pressure at reflux were prognostic for the resolution of reflux (13); in another, reflux at low bladder volumes was associated with increased renal scarring (7). The ability to predict the prognosis for a particular patient at the time of diagnosis may lead to better treatment decisions and follow-up...

show abstract

Relationship Among Vesicoureteral Reflux, Urinary Tract Infection and Renal Damage in Children

Cited by 135 publications

References 21 publications

Association of Vesicoureteric Reflux (VUR) in Children with Symptomatic Urinary Tract Infection (UTI) - in a Tertiary Care Hospital, Dhaka, Bangladesh

Association of Vesicoureteric Reflux (VUR) in Children with Symptomatic Urinary Tract Infection (UTI) - in a Tertiary Care Hospital, Dhaka, Bangladesh

645 Sonographic Assessment of the Effect of Vesicoureteral Reflux and Urinary Tract Infections on Growth of the Pediatric Solitary Kidney

New Quantitative Parameters for Evaluating Radionuclide Cystography and Their Value in Understanding the Physiology of Reflux

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