Clinical profile of children with primary vesicoureteric reflux and its association with renal parenchymal scarring

Abstract

V esicoureteric reflux (VUR) is an important predisposing factor for urinary tract infection (UTI) and renal parenchymal scarring [1]. VUR describes retrograde flow of urine from urinary bladder into ureter and kidney. VUR is called primary when it is an isolated finding and referred to as secondary, when associated with other urological anomalies such as posterior urethral valve, renal agenesis, and multicystic dysplastic kidney [1].Accurate prevalence of VUR is not known as many are asymptomatic and diagnostic testing is performed only when clinically indicated. About 30-40% of children and 40-50% of neonates with UTI have VUR [2]. Of children with primary VUR, 30-50% may develop renal parenchymal scarring and risk of scarring is reported to be highest in young children [2]. About 5-10% of children with reflux nephropathy may progress to chronic kidney disease (CKD) in late childhood. Reflux nephropathy is also the most common cause of severe hypertension and CKD in childhood and adolescence [2]. The objectives were to study the clinical profile of children with primary VUR and to assess the relationship with grades of primary VUR and renal parenchymal scarring. MATERIALS AND METHODSThis was a hospital-based prospective observational study conducted over a period of 18 months, from December 2017 to June 2019. Fifty children between 1 month and 5 years of age,