Department of Pediatrics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.

To evaluate the association between primary vesicoureteral reflux (VUR) and renal scarring in children using 99 m Technetium-labelled dimercaptosuccinic acid (DMSA).

Children attending at Songklanagarind Hospital from 1987 to 2002 were evaluated.

Ages at diagnosis of VUR in 46 boys and 52 girls were 1.1 +/- 1.6 and 2.9 +/- 2.5 years, median 0.6 and 2.3 years, respectively (P < 0.001). DMSA scans were performed at 4.1 +/- 3.6 years. Renal parenchymal damage was detected in 34 kidneys (22%) of 154 demonstrated refluxing ureters, and one kidney (2%) of 42 non-refluxing ureters (P = 0.002). Of 79 refluxing ureters in boys and 75 refluxing ureters in girls, there were 25 and nine renal scars, respectively (32% and 12%, P = 0.003). Renal scars in VUR grades I-V were 11%, 7%, 12%, 44% and 64%, respectively (P < 0.001). Multivariate analysis revealed that high grade VUR (P < 0.001), age of diagnosis of VUR greater than 5 years (P = 0.001), and male gender (P = 0.002) were the most significant risk factors for renal scarring.

High-grade VUR, age of diagnosis of VUR greater than 5 years and male gender were the most significant risk factors for renal scarring.

Written by
Vachvanichsanong P, Dissaneewate P, Thongmak S, Lim A.

Reference
Nephrology (Carlton). 2008 Feb;13(1):38-42.
doi:10.1111/j.1440-1797.2007.00906.x

PubMed Abstract
PMID:18199100

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