Impact of early screening for reflux in siblings on the detection of renal damage

BJU International
Anne-Marie HouleValérie Gaudreault

Abstract

To assess the impact of screening siblings after detecting significant vesico-ureteric reflux (VUR) and renal scarring, as such screening might identify patients with VUR before urinary tract infections develop, but might also detect clinically insignificant VUR. We used a previously reported screening protocol to assess the clinical characteristics of patients, including the incidence of renal scarring, and their siblings, and compared the results. In all, 123 children were screened and 44 (36%) had VUR on voiding cystography. The median (range) age at screening was 9 (1-90) months. The grades of VUR detected were < III in 61% and > or = III in 39%; VUR was bilateral in 48%. In all, 37 siblings with VUR were assessed by ultrasonography; 70% were normal, including 12 (32%) children with VUR of grade > or = III. When used, renal scintigraphy was normal in 74% of siblings, vs 18% of index patients. However, when screened after 2 years old, siblings had twice the risk of already having renal damage on renal scintigraphy (P = 0.04). Early screening (< or = 2 years) appears to be more protective for avoiding renal damage than screening older patients. Thus we propose early screening in asymptomatic siblings to detect VUR before it b...Continue Reading

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Citations

Jan 9, 2013·Der Urologe. Ausg. A·R SteinR Beetz
Jul 25, 2006·Pediatric Radiology·Richard S LeeJeanne S Chow
Sep 5, 2008·Advances in Urology·Sumit Dave, Antoine E Khoury
Dec 18, 2015·Der Urologe. Ausg. A·J StraubM Riccabona
Jun 16, 2012·European Urology·Serdar TekgülUNKNOWN European Association of Urology
Aug 21, 2009·The Journal of Urology·Maria Menezes, Prem Puri
Mar 28, 2006·Journal of the American Society of Nephrology : JASN·Kalyani R VatsAbhay N Vats

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