Renal ultrasound volume in children with primary vesicoureteral reflux allows functional assessment

Weitz, Marcus; Licht, Christoph; Müller, Mark; Haber, Peter

doi:10.1016/j.jpurol.2013.03.007

Cited by 8 publications

(10 citation statements)

References 38 publications

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“…While SRF in children was estimated by measuring kidney size on US in a limited number of studies, those that focused on infants or very young children were scarce. 19,20 Kidney length is the simplest and most commonly used approach to evaluate renal size. In the present study, a cutoff of 4.97 cm showed high specificity, indicating that a kidney longer than this is less likely to be small kidney.…”

Section: Discussionmentioning

confidence: 99%

What are the Optimal Renal Ultrasound Parameters for Detecting Small Kidney in Young Children?

Kon¹,

Nakamura²,

Moriya³

et al. 2021

RRU

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Introduction: Recent guidelines do not recommend routine screening of vesicoureteral reflux after a first febrile urinary tract infection in children without abnormal findings on ultrasound or atypical/recurrent urinary tract infection. Currently, there are no clear ultrasonographic parameters for detecting abnormalities in renal size, especially in young children. The aim of the present study was to determine an optimal cutoff value for detecting small kidney in children without apparent congenital anomalies except vesicoureteral reflux by retrospective chart review. Patients and Methods: Children aged ≤3 years who had undergone nuclear renal scans and ultrasound were enrolled. Small kidney was defined as split renal function of <40%. Optimal cutoff values of various ultrasonographic parameters for detecting small kidney were calculated. Results: Of the 69 children included in the present study, small kidney was identified in 20. There was a significant difference in renal size between each kidney in patients with small kidney, whereas there was no significant difference in those without small kidney. With a ratio of estimated renal area of 74.26%, maximum area under the curve with the highest sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate were obtained. In addition, simple measurement of renal length with a cutoff of 4.97 cm showed high specificity comparable with estimated renal area. Conclusion: Small kidney may be screened by two-dimensional measurement on ultrasonographic examination, even in young children. With the cutoff described, risk stratification or an individualized approach may be possible.

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Section: Discussionmentioning

confidence: 99%

What are the Optimal Renal Ultrasound Parameters for Detecting Small Kidney in Young Children?

Kon¹,

Nakamura²,

Moriya³

et al. 2021

RRU

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show abstract

“…11 The first 2 years of life are of crucial importance for kidney development, with particular sensitivity for developing renal scars from UTIs. 8 The risk of developing a first renal scar decreases after 4 years of life but is not eliminated. 61 Conservative management should be dismissed in all patients with febrile breakthrough infections despite prophylaxis, and intervention should be considered.…”

Section: Current Challenges and Controversiesmentioning

confidence: 99%

“…21 Ultrasound measurement of relative renal volume is capable of assessing split renal function in children with primary VUR. 8 Deteriorated renal status is more common in cases diagnosed prenatally than in those detected after UTI. 122 Recurrent UTIs, renal scarring, and further renal damage occur most frequently among children under surveillance without treatment than in the CAP group.…”

Section: Risk Factorsmentioning

confidence: 99%

“…7 Although less than 1% of childhood UTI leads to chronic kidney insufficiency, there is an association between vesicoureteral reflux (VUR), reflux nephropathy, and end-stage renal disease. 8 Reflux nephropathy accounts for 25% of children with end-stage renal failure requiring chronic dialysis or renal transplantation. 7 Primary VUR is a situation where VUR is an isolated finding not related to any known complex congenital urinary tract anomaly, multiorgan malformation syndrome, neuromuscular bladder dysfunction (neurogenic bladder, nonneurogenic neurogenic bladder, and bladder dysfunction), or bladder outlet obstruction (congenital posterior urethral valves in boys) with consequent elevated bladder pressure at rest and during micturition.…”

Section: Introductionmentioning

confidence: 99%

“…9 With a prevalence of 1% to 2%, primary VUR is one of the most common and controversial urological abnormalities in children. 8 VUR is the most frequent predisposing factor for UTI, 10 and 30% to 50% of children with UTI have VUR. 11 In spite of VUR and APN frequently occurring independently of one another, VUR is a precipitating factor in APN 5 and a risk factor for renal scar formation, the incidence of which is significantly correlated with VUR grade.…”

Section: Introductionmentioning

confidence: 99%

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Predictive Risk Factors in Childhood Urinary Tract Infection, Vesicoureteral Reflux, and Renal Scarring Management

Roupakias

Sinopidis

Karatza

et al. 2013

Clin Pediatr (Phila)

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Approaches to the management of children with urinary tract infection (UTI), vesicoureteral reflux (VUR), and renal scars have been challenged and have become controversial over the past decade. It is difficult to determine when, how, and which patients will benefit from the diagnosis and management of this condition. Therefore, the issues of diagnostic imaging, observation, follow-up, and intervention tend to be decided more on a case-by-case basis, rather than by using an algorithm. Over the past few years, there have been advances in the identification of risk factors that predispose patients with UTI to present with VUR, to develop recurrent UTIs and renal scars, to have deteriorating renal function, to show VUR improvement and/or spontaneous resolution, and to be candidates for and benefit from early surgical intervention.

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Kidney outcomes in early adolescence following perinatal asphyxia and hypothermia-treated hypoxic-ischaemic encephalopathy

et al. 2022

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Background Acute kidney injury (AKI) remains common among infants with hypothermia-treated hypoxic-ischaemic encephalopathy (HIE). Little is known about long-term kidney outcomes following hypothermia treatment. We recently reported that 21% of survivors of hypothermia-treated HIE had decreased estimated glomerular filtration rate (eGFR) based on plasma creatinine in early adolescence. Here, we assessed kidney functions more comprehensively in our population-based cohort of children born in Stockholm 2007–2009 with a history of hypothermia-treated HIE. Methods At 10–12 years of age, we measured cystatin C (cyst C) to estimate GFR. Children with decreased cyst C eGFR also underwent iohexol clearance examination. We measured urine-albumin/creatinine ratio, blood pressure (BP) and kidney volume on magnetic resonance imaging. Fibroblast growth factor 23 (FGF 23) levels in plasma were assessed by enzyme-linked immunosorbent assay (ELISA). Outcomes were compared between children with and without a history of neonatal AKI. Results Forty-seven children participated in the assessment. Two children (2/42) had decreased cyst C eGFR, for one of whom iohexol clearance confirmed mildly decreased GFR. One child (1/43) had Kidney Disease Improving Global Outcomes (KDIGO) category A2 albuminuria, and three (3/45) had elevated office BP. Subsequent ambulatory 24-h BP measurement confirmed high normal BP in one case only. No child had hypertension. Kidney volume and FGF 23 levels were normal in all children. There was no difference in any of the parameters between children with and without a history of neonatal AKI. Conclusion Renal sequelae were rare in early adolescence following hypothermia-treated HIE regardless of presence or absence of neonatal AKI. Graphical abstract

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Renal ultrasound volume in children with primary vesicoureteral reflux allows functional assessment

Cited by 8 publications

References 38 publications

What are the Optimal Renal Ultrasound Parameters for Detecting Small Kidney in Young Children?

What are the Optimal Renal Ultrasound Parameters for Detecting Small Kidney in Young Children?

Predictive Risk Factors in Childhood Urinary Tract Infection, Vesicoureteral Reflux, and Renal Scarring Management

Kidney outcomes in early adolescence following perinatal asphyxia and hypothermia-treated hypoxic-ischaemic encephalopathy

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