Congenitally Small Kidneys With Reflux as a Common Cause of Nephropathy in Boys

Hiraoka, M; Hori, Chikahide; Tsukahara, H.; Kasuga, Kenkou; Ishihara, Yasuhito; Sudo, Mariko

doi:10.1016/s0022-5347(01)63128-8

Cited by 8 publications

(15 citation statements)

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“…However, the study of Hiraoka et al . reported the incidence of dwarf kidney as one in 500 infants (boys and girls), while in boys only the incidence rose to 1 in 300, by ultrasonographic screening 19 . In the study of Hiraoka et al .…”

Section: Resultsmentioning

confidence: 97%

Ultrasound screening for renal and urinary tract anomalies in healthy infants

Tsuchiya

Hayashida

Yanagihara

et al. 2003

Pediatrics International

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Section: Resultsmentioning

confidence: 97%

Ultrasound screening for renal and urinary tract anomalies in healthy infants

Tsuchiya

Hayashida

Yanagihara

et al. 2003

Pediatrics International

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“…Renal changes observed on renoscintigraphy comprise not only acquired renal changes due to pyelonephritis, but also congenital renal maldevelopment [9,17]. Focal renal changes on acute-phase renoscintigraphy, which were observed to disappear with subsequent renoscintigraphy and were considered as inflammatory changes associated with acute pyelonephritis, were found in none of the children who received treatment within 24 h of the development of the disease.…”

Section: Discussionmentioning

confidence: 99%

Early treatment of urinary infection prevents renal damage on cortical scintigraphy

et al. 2002

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Diagnosis of urinary infection in young children is often delayed, which may result in renal damage. However, it remains to be clarified how soon the treatment should be started to prevent renal changes. The present study prospectively enrolled young children with diagnosis of their first febrile urinary infection who underwent technetium-99m dimercaptosuccinate renal cortical scintigraphy within 120 h of initiation of treatment. Patients with abnormal renoscintigraphy received antibiotics for 2 weeks and scintigraphy was repeated 1 year later. Twenty-two children were enrolled from July 1995 through March 2000. Acute-phase renoscintigraphy identified focal defects in 0 of the 14 children who were treated within 24 h of the disease, 1 of the 3 treated in 24-48 h, and 2 of the 5 treated in 48-72 h. Repeat renoscintigraphy showed disappearance of the focal defects in all 3 children. The present study has shown that early treatment within 24 h of onset of the fever due to urinary infection should deter renal changes. Fever for more than 24 h prior to diagnosis indicates a high risk for renal changes and needs an immediate effective treatment to avoid renal damage.

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“…Urethral early obstruction in fetal life is known to cause both renal maldevelopment and ureteral reflux [27]. Some authors [28] have hypothesized the role of mutations of unknown genes with incomplete penetrance and predominant expression in males. Primary VUR diagnosed at an older age after UTI is usually mild and more common in females [11,14].…”

Section: Discussionmentioning

confidence: 99%

Primary vesicoureteric reflux and renal damage in the first year of life

Lama¹,

Russo²,

Rosa³

et al. 2000

Pediatric Nephrology

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We retrospectively examined 93 children (47M/46F) with primary vesicoureteric reflux (VUR) followed for a mean period of 3.5 years. They were divided into two groups. Group A included 34 babies (25M/9F) with a prenatal diagnosis of pelvic dilatation. Mean age at presentation was 12 days and no urinary tract infection (UTI) occurred before our first examination. VUR was unilateral in 21 (62%) patients and bilateral in 13 (38%). It was mild (grades I-III) in 12 (25%) refluxing renal units (RRU) and severe (grades IV-V) in 35 (75%). Renal damage (RD) was present, at diagnosis, in 40 (85%) RRU. There was a greater prevalence of abnormal kidneys in male units (88%) than in female units (75%). Group B included 59 infants (22M/37F) less than 1 year old with UTI. The mean age at first examination was 7.6 months. VUR was unilateral in 32 (54%) infants and bilateral in 27 (46%), mild in 60 (70%) RRU and severe in 26 (30%). At diagnosis, 54 (63%) RRU presented RD, which was more common in females (66%) than in males (44%). Our study confirms that primary VUR associated with prenatal hydronephrosis usually affects males and is severe. VUR diagnosed after UTI, instead, is more common in females and is frequently mild. Although in the first type of reflux RD is often present at diagnosis, then probably congenital, it may always progress after UTI; hence the importance of early diagnosis and careful follow-up in each infant with primary VUR.

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Congenitally Small Kidneys With Reflux as a Common Cause of Nephropathy in Boys

Cited by 8 publications

References 0 publications

Ultrasound screening for renal and urinary tract anomalies in healthy infants

Ultrasound screening for renal and urinary tract anomalies in healthy infants

Early treatment of urinary infection prevents renal damage on cortical scintigraphy

Primary vesicoureteric reflux and renal damage in the first year of life

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