Vesicoureteral Reflux

Elder, Jack S.

doi:10.1016/b978-1-4377-0755-7.00533-9

Cited by 3 publications

(6 citation statements)

References 22 publications

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“…UTI is a common bacterial infection in infants and children, with approximately 1% of boys and 1–3% of girls developing a UTI during childhood [ 16 ]. APN, which refers to infection of the renal parenchyma, may cause chronic renal damage.…”

Section: Discussionmentioning

confidence: 99%

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Plasma Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Renal Parenchymal Involvement in Infants With Febrile Urinary Tract Infection: A Preliminary Study

2018

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BackgroundUrinary tract infection (UTI) is the most common bacterial infection in infants. Renal parenchymal involvement is an important prognostic factor; however, early detection of parenchymal involvement in UTI may be difficult during infancy. This study aimed to assess whether a recently established biomarker of UTI, neutrophil gelatinase-associated lipocalin (NGAL), can serve as a useful marker for the detection of cortical defects (CD) and to determine the appropriate diagnostic cut-off value of NGAL in infants with febrile UTI.MethodsInfants hospitalized for febrile UTI were divided into two groups according to the presence of cortical defects on dimercaptosuccinic acid (DMSA) scintigraphy. Among 64 enrolled infants, 43 (67%) had CD (UTI-CD) and 21 (33%) had no CD (UTI-ND). The white blood cell count, C-reactive protein, and plasma NGAL (pNGAL) levels were determined before antibiotic therapy and compared between the two groups.ResultspNGAL level was significantly higher in the UTI-CD group than in the UTI-ND group (340 µg/L vs 214 µg/L, P=0.002). Multivariate analysis showed that pNGAL level was the only independent predictor of CD (odds ratio 2.759, P=0.039). In the ROC curve analysis, pNGAL showed the highest area under the curve (0.745; 95% confidence interval, 0.561–0.821; P=0.014). The appropriate cut-off value of pNGAL was 267 µg/L (sensitivity, 72.1%; specificity, 71.4%).ConclusionspNGAL was found to be a useful marker for early prediction of renal parenchymal involvement in infants with febrile UTI.

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Section: Discussionmentioning

confidence: 99%

“…Renal scarring may lead to hypertension, renal insufficiency, and end-stage renal failure. In clinical practice, some inflammatory markers have been used to detect infection of the renal parenchyma, but these markers may not accurately reflect the CD [ 6 16 ].…”

Section: Discussionmentioning

confidence: 99%

Plasma Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Renal Parenchymal Involvement in Infants With Febrile Urinary Tract Infection: A Preliminary Study

2018

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“…The normal configuration of ureteral orifices is oblique. In VUR, the intramural tunnels shorten due to progressive lateral displacement of the ureteral orifices 1 . Therefore, as ureteral orifices move laterally, the ureteral jet will become vertical 6 .…”

Section: Introductionmentioning

confidence: 99%

“…V esicoureteral reflux (VUR) occurs when urine flows backward from the bladder backward to the ureters and kidneys. 1 VUR can lead to severe complications such as urinary tract infection, renal scarring, hypertension, and renal failure. 2 Up to 30% of patients will develop new infections, but only a small percentage will develop long-term kidney complications.…”

Section: Introductionmentioning

confidence: 99%

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Color Doppler Ultrasound's Utility in Detecting Vesicoureteral Reflux Using the Ureteral Jet Angle

Zadeh

Sadeghi‐Bojd

Ansari‐Moghaddam

et al. 2022

J of Ultrasound Medicine

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Objectives This study hypothesizes using color Doppler ultrasound to measure ureteral jet angles (UJA) as a diagnostic screening tool for reflux. Methods The present prospective cohort study included 122 patients and 238 renal unit pediatric patients suspected of VUR who presented to our hospital between 2019 and 2021. All patients underwent ultrasonography and VCUG, and the UJA was measured color Doppler evaluation of the ureteral jet. The UJA was compared with the VCUG findings in patients with and without reflux. SPSS 26 was used to analyze the data. Results A total of 96 patients and 139 renal units exhibited reflux. The mean ureteral jet angle in refluxing units was 60.47 + 16.66 degrees, whereas, it was 42.59 + 13.26 degrees in non‐refluxing units, a significant difference between the two groups (P < .001). The mean ureteral jet angle was 42.59, 45.89, 60.32, 68.23, and 56.16, for reflux grading from 0 to 5 (except grade 1), respectively. The angle value in each reflux grade increased significantly except for grade 5. For reflux detection (grade I–V), a cut‐off angle of 50 degrees was associated with sensitivity and specificity of 70 and 79, respectively. Grade IV/V reflux can be diagnosed with a sensitivity of 70% and specificity of 84% using a cut‐off angle of 68 degrees or greater. Conclusions UJA detection via color Doppler ultrasound demonstrates high accuracy, is non‐invasive method can be utilized as an alternative primary diagnostic tool or in follow‐up cases of VUR in children.

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Role of Bladder Dysfunction in Vesicoureteral Reflux

Kieran

Cooper

2014

Curr Bladder Dysfunct Rep

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Vesicoureteral Reflux

Cited by 3 publications

References 22 publications

Plasma Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Renal Parenchymal Involvement in Infants With Febrile Urinary Tract Infection: A Preliminary Study

Plasma Neutrophil Gelatinase-Associated Lipocalin as a Predictor of Renal Parenchymal Involvement in Infants With Febrile Urinary Tract Infection: A Preliminary Study

Color Doppler Ultrasound's Utility in Detecting Vesicoureteral Reflux Using the Ureteral Jet Angle

Role of Bladder Dysfunction in Vesicoureteral Reflux

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