PMID- 11458111
OWN - NLM
STAT- MEDLINE
DCOM- 20010809
LR  - 20190621
IS  - 0022-5347 (Print)
IS  - 0022-5347 (Linking)
VI  - 166
IP  - 2
DP  - 2001 Aug
TI  - Reflux nephropathy in infancy: a comparison of infants presenting with and 
      without urinary tract infection.
PG  - 648-50
AB  - PURPOSE: We compared the incidence of renal scarring in infants with high grade 
      vesicoureteral reflux in those presenting with and without urinary tract 
      infection. METHODS AND METHODS: We reviewed the medical records of 81 male and 46 
      female infants (194 renal refluxing units) with a mean age of 4 months who had 
      grade IV or V primary vesicoureteral reflux and underwent an anti-reflux 
      procedure between 1984 and 1997. Dimercapto-succinic acid (DMSA) scans and 
      voiding cystourethrography were performed in all cases. Patients were followed 
      for 2 to 16 years, including 90% for greater than 3 years. Renal ultrasound and 
      DMSA scan were done at followup. RESULTS: A total of 97 patients (76%) (148 
      refluxing renal units) presented clinically with urinary tract infection. The 
      initial DMSA scan demonstrated renal scarring in 40 of the 106 grade IV (38%) and 
      28 of the 42 grade V (67%) refluxing renal units. There was no scarring on 
      followup in previously normal refluxing renal units. Of the patients 30 (24%) (46 
      refluxing renal units) were diagnosed before a urinary tract infection developed, 
      16 underwent screening due to vesicoureteral reflux in a sibling and in 10 reflux 
      was initially suspected due to hydronephrosis on prenatal ultrasound. In the 
      remaining 4 patients vesicoureteral reflux was suspected during abdominal 
      ultrasound to investigate abdominal pain, jaundice, associated hypospadias and 
      fetal alcohol syndrome, respectively. DMSA scan showed evidence of scarring in 6 
      of 21 grade IV (29%) and 9 of 25 grade V (36%) refluxing renal units in this 
      group. Followup revealed scarring in only 1 previously normal refluxing renal 
      unit. CONCLUSIONS: The incidence of reflux nephropathy in primary grade V 
      vesicoureteral reflux is lower in cases detected by screening and with treatment 
      it remained lower than in cases of urinary tract infection that presented 
      clinically. Early treatment of grade V vesicoureteral reflux made possible by 
      screening may prevent renal damage.
FAU - Sweeney, B
AU  - Sweeney B
AD  - Children's Research Centre, Our Lady's Hospital for Sick Children, Dublin, 
      Ireland.
FAU - Cascio, S
AU  - Cascio S
FAU - Velayudham, M
AU  - Velayudham M
FAU - Puri, P
AU  - Puri P
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - J Urol
JT  - The Journal of urology
JID - 0376374
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - Female
MH  - Humans
MH  - Hydronephrosis/complications
MH  - Infant
MH  - Infant, Newborn
MH  - Kidney/pathology
MH  - Kidney Diseases/*etiology
MH  - Male
MH  - Retrospective Studies
MH  - Urinary Tract Infections/*complications
MH  - Vesico-Ureteral Reflux/*complications/pathology
EDAT- 2001/07/18 10:00
MHDA- 2001/08/10 10:01
CRDT- 2001/07/18 10:00
PHST- 2001/07/18 10:00 [pubmed]
PHST- 2001/08/10 10:01 [medline]
PHST- 2001/07/18 10:00 [entrez]
AID - S0022-5347(05)66036-3 [pii]
AID - 10.1016/s0022-5347(05)66036-3 [doi]
PST - ppublish
SO  - J Urol. 2001 Aug;166(2):648-50. doi: 10.1016/s0022-5347(05)66036-3.