Vesicoureteric reflux in Kuwaiti children with first febrile urinary tract infection

Abstract

The prevalence of vesicoureteric reflux (VUR) in children with urinary tract infection (UTI) varies among different racial groups. The purpose of this study was to determine the frequency of VUR and associated renal changes in a group of Arab Kuwaiti children with their first documented febrile UTI and to compare our findings with those reported from other racial groups. One hundred and seventy-four children (38 males and 136 females) fulfilled the study criteria and were divided into three age groups (<1 year, 1-5 years, and >5 years). Patients in each group had both micturating cystourethrography (MCUG) and 99m-Tc-dimercaptosuccinic acid (DMSA) renal scan after diagnosis. VUR was detected in 39 children (22%). Two-thirds of cases had mild reflux (grade I and II). Females ( n=32) had more reflux than males ( n=7) (24% vs. 18%). Sixty-three patients (36%) had abnormal (DMSA) renal scans (acute pyelonephritis [AP] or renal scars). Of these, 79% were children below 5 years. Abnormal DMSA scans were found in 4 of 38 males (11%) versus 59 of 136 females (43%). Abnormal scans in children with VUR were seen in 1 of 7 males (14%) versus 19 of 32 females (59%). In total, the combination of abnormal scan with VUR occurred in 1 of 38 males (3%) and in 19 of 136 females (14%), whereas abnormal scan without demonstrable VUR was seen in 3 of 38 males (8%) versus 40 of 136 females (29%). Our data showed that the frequency of VUR in Arab Kuwaiti children with febrile UTI is midway between Caucasian and other racial groups. In this study, males had a lower-risk profile than females, the latter having a higher rate of reflux as well as a higher rate of abnormal DMSA scans, irrespective of demonstrable VUR.

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

“…In a study from USA Chand et al found that age wise incidence of VUR was 52% in 0-2 years, 26% in 3-6 years, 18% in 7-11 years and 4% in 12-21 years of age. 2 Similar result was found by Zaki et al 31 In our study, the incidence and severity of grades of VUR in children is higher than the studies done by Chand et al and Zaki et al 2,31 The lack of antenatal sonologic evaluation and late referral of the patients are the two important risk factors that differs the present study with others. 32,33 In our study grade III-V reflux was present in 31 renal units which comprises 88.56% of the refluxing units .This figure is much higher than the study by Orellana P et al where moderate to severe grades were present in43.16% kidneys.…”

“…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. In this study higher frequency of VUR has been found in older children (Table IV).…”

The relationship between urinary tract infections and vesicoureteral reflux in Turkish children

“…Several studies have shown that radiological abnormalities exist in as many as 25-55% of children after their first UTI, with one-third having VUR [4][5][6][7][8][9][10]. There was a high incidence of acute pyelonephritis (APN) in the presence of VUR, but APN does not necessarily need VUR for its development.…”

Effects of Methanol Extract of Green Tea on Biofilm Formation of Staphylococcus aureus

“…Among them, 16% of patients were diagnosed with VUR grade I and II, while 19.5% of the cases were diagnosed with VUR III-V. This is slightly higher than that reported in Turkey (19.4) and lower than that found in Kuwait (33%) (6,18,22,23). All patients with grade I and II were referred to the pediatric department for follow-up and they were excluded from this study, whereas higher grades were corrected endoscopically.…”