Risk factors for renal scarring and clinical morbidity in children with high-grade and low-grade primary vesicoureteral reflux

Mathias, Sitarah; Greenbaum, Larry A.; Shubha, Attibele Mahadevaiah; Raj, John A. Michael; Das, Kanishka; Pais, Priya

doi:10.1016/j.jpurol.2021.12.017

Cited by 11 publications

(4 citation statements)

References 43 publications

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“…Mattoo et al 5 found in a prospective randomized controlled clinical study (RIVUR) that children with IV-V grade VUR were more likely to develop BT-UTI and renal scars, 24.2 and 1.88 times higher than those with I–III grade VUR, respectively. Sitarah Mathias et al 27 also found that patients with high-grade VUR patients were more likely than those with low-grade VUR patients to have renal scarring (75% vs. 49%, p < 0.01), low eGFR (23% vs. 13%, p Z 0.04) and significant hypertension (26% vs. 13%, p Z 0.02). In our study, neither the univariate nor multivariate analysis found a correlation between VUR grade and NRS.…”

Section: Discussionmentioning

confidence: 90%

“…The mechanism of VUR-induced regurgitant nephropathy is not well understood. Repeated urinary tract infections and immune impairment are thought to contribute to regurgitant nephropathy 5 , 6 . Current therapeutic strategies for VUR are aimed at reducing the occurrence of new BT-UTIs and kidney function impairment 7 , 8 .…”

Section: Introductionmentioning

confidence: 99%

“…Current therapeutic strategies for VUR are aimed at reducing the occurrence of new BT-UTIs and kidney function impairment 7 , 8 . Recurrent BT-UTI in VUR children is prone to new renal scarring, which can also affect their long-term prognosis, with the potential risk of developing hypertension, albuminuria, renal impairment, and even renal failure 6 . This study aimed to analyze the clinical data of children receiving CAP treatment for VUR in our hospital from 2016 to 2019, with the purpose of summarizing the risk factors for new kidney scarring in children with VUR.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for new renal scarring in children with vesicoureteral reflux receiving continuous antibiotic prophylaxis

Su,

Zhuo,

Zhang

et al. 2024

Sci Rep

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To investigate the risk factors for new renal scarring (NRS) in children with vesicoureteral reflux (VUR) receiving continuous antibiotic prophylaxis (CAP). This was a single-center cohort study. The clinical data of 140 children with grade I–V VUR receiving CAP were analyzed. In this study, exposure variables were sex, younger age at the initial diagnosis of UTI ≤ 12 months, the occurrence of breakthrough urinary tract infection (BT-UTI), high-grade VUR, bilateral VUR, etiology, presence of renal scarring at the initial diagnosis and ultrasound abnormalities. The outcome was NRS. A total of 140 children were included in the risk factor analysis of NRS, 73 of whom experienced NRS, an incidence rate of 52.14%. Multivariate Cox regression suggested that the presence of renal function impairment after the initial diagnosis of UTI (OR 3.411, 95% CI 1.5751–6.646) and the occurrence of BT-UTI while receiving CAP (OR 1.995, 95% CI 1.089–2.958) were independent risk factors for NRS. Multivariate Cox regression showed that high-grade VUR had no significant effects on NRS (OR 0.940, 95% CI 0.462–1.912, P = 0.864). No significant difference was identified in multivariate Cox regression analysis in the IV–V group (vs I–III group) (OR 0.960, 95% CI 0.565–1.633, P = 0.960). Renal function impairment after the initial diagnosis of UTI and the occurrence of BT-UTI while receiving CAP were independent risk factors for NRS. Neither univariate analysis nor multivariate analysis found a correlation between VUR grade and NRS.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk factors for new renal scarring in children with vesicoureteral reflux receiving continuous antibiotic prophylaxis

Su,

Zhuo,

Zhang

et al. 2024

Sci Rep

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“…[12][13][14][15] In contrast, chronic renal scarring can be detected in the delayed phase, which indicates the risk of accompanying chronic complications. [15][16][17][18][19][20] Thus, the timing of the study is important; however, a report showed that some cases of renal scarring, which was detected in the first chronic phase DMSA renal scintigraphy, recovered in the second chronic phase DMSA renal scintigraphy. 21 To our knowledge, there are no reports focusing on image findings that were associated with the improvement in renal scarring shown in DMSA scintigraphy after a UTI.…”

Section: Introductionmentioning

confidence: 99%

Complete Remission of Renal Scarring in Follow-Up DMSA Renal Scintigraphy After Urinary Tract Infection

Hosokawa,

Uchiyama

2023

Clin Pediatr (Phila)

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Our study aimed to investigate the association between the characteristics of patients/images and complete remission of renal scarring shown in the first chronic phase Technetium-99m dimercaptosuccinic acid (DMSA) renal scintigraphy images in children with urinary tract infection (UTI). Fifty children, who underwent the chronic phase of DMSA scintigraphy more than twice following UTI diagnosis and had renal scarring in the first chronic phase DMSA renal scintigraphy, were enrolled. They were classified into 2 groups: with and without complete remission of renal scarring on the second chronic phase DMSA renal scintigraphy. Renal scarring was classified into 3 grades based on severity per the image findings. Seven cases had complete remission from renal scarring. There were significant differences in age and severity. Renal scarring might be completely reversed in young children without severe findings on DMSA renal scintigraphy. Additional chronic phase examination may aid in follow-up completion and patients’ peace of mind.

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Update and Summary of the European Association of Urology/European Society of Paediatric Urology Paediatric Guidelines on Vesicoureteral Reflux in Children

Gnech,

't Hoen,

Zachou

et al. 2024

European Urology

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Risk factors for renal scarring and clinical morbidity in children with high-grade and low-grade primary vesicoureteral reflux

Cited by 11 publications

References 43 publications

Risk factors for new renal scarring in children with vesicoureteral reflux receiving continuous antibiotic prophylaxis

Risk factors for new renal scarring in children with vesicoureteral reflux receiving continuous antibiotic prophylaxis

Complete Remission of Renal Scarring in Follow-Up DMSA Renal Scintigraphy After Urinary Tract Infection

Update and Summary of the European Association of Urology/European Society of Paediatric Urology Paediatric Guidelines on Vesicoureteral Reflux in Children

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