Renal parenchymal damage in intermediate and high grade infantile vesicoureteral reflux

The Journal of Urology
Nochiparambil MohananP Puri

Abstract

The association of vesicoureteral reflux, urinary tract infection and renal scarring is well recognized. We evaluated the incidence of renal parenchymal scarring in a large series of infants with primary high grade vesicoureteral reflux. The medical records of 549 consecutive infants with primary high grade vesicoureteral reflux between 1985 and 2006 were reviewed. A total of 473 infants (86.1%) presented with febrile urinary tract infections, 63 (11.5%) were screened for sibling vesicoureteral reflux and 13 (2.4%) were investigated because of prenatally diagnosed hydronephrosis. Age at diagnosis was defined as patient age at the first voiding cystourethrogram. Renal parenchymal scarring was evaluated by dimercapto-succinic acid scan and classified into 3 groups, including mild--focal defects with between 40% and 45% relative uptake of renal radionuclide, moderate--relative uptake between 20% and 40%, and severe--a shrunken kidney with relative uptake less than 20%. Of the 549 infants 292 (53%) were boys and 257 (47%) were girls with a median age of 6 months (range 2 to 12). Reflux was unilateral in 160 and bilateral in 389 (938 ureters). Reflux grade was II to V in 19, 372, 458 and 89 ureters, respectively. All patients with g...Continue Reading

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Citations

Jun 16, 2012·European Urology·Serdar TekgülUNKNOWN European Association of Urology
Aug 24, 2010·The Journal of Urology·Basim S AlsaywidGrahame H H Smith
Aug 21, 2009·The Journal of Urology·Ilene Yi-Zhen WongLinda Dairiki Shortliffe
Apr 24, 2016·Journal of Pediatric Urology·Kimihiko MoriyaNobuo Shinohara
Apr 5, 2011·Korean journal of urology·Hyeon Chan JangJae Shin Park
Aug 25, 2011·Nature Reviews. Urology·Prem PuriDavid E Barton
Mar 23, 2010·The Journal of Urology·David S HainsCarlton M Bates
Jan 26, 2012·Developmental Dynamics : an Official Publication of the American Association of Anatomists·Ashley CarpenterKirk M McHugh

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