Evolution and prognosis value of intrarenal reflux

Boubnova, Julia; Sergent-Alaoui, A.; Deschênes, Georges; Audry, G.

doi:10.1016/j.jpurol.2010.09.015

Cited by 17 publications

(17 citation statements)

References 26 publications

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“…9 A recent prospective case-control study found that baseline Tc 99m DMSA findings were worse in an IRR group than a non-IRR group, although similar rates of reflux resolution and urinary tract infections were observed in both groups with medical treatment. 19 Similarly, a retrospective study of 50 patients with IRR and VUR demonstrated that cortical defects on Tc 99m DMSA correlated well with sites of IRR. 5 Some authors advocate that interventions such as ureteral reimplantation should be considered sooner in children with IRR than in those without IRR.…”

Section: Discussionmentioning

confidence: 94%

“…Although clinical management decisions are based primarily on reflux grade and not on the presence or absence of IRR, its presence aids risk stratification and may influence management 9. A recent prospective case‐control study found that baseline Tc 99m DMSA findings were worse in an IRR group than a non‐IRR group, although similar rates of reflux resolution and urinary tract infections were observed in both groups with medical treatment 19. Similarly, a retrospective study of 50 patients with IRR and VUR demonstrated that cortical defects on Tc 99m DMSA correlated well with sites of IRR 5.…”

Section: Discussionmentioning

confidence: 99%

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Intrarenal Reflux

Colleran

Barnewolt

Chow

et al. 2016

J of Ultrasound Medicine

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Vesicoureteral reflux (VUR) is a childhood condition that is usually diagnosed by fluoroscopic voiding cystourethrography (VCUG). Intrarenal reflux (IRR) of infected urine is believed to play an important role in the pathogenesis of reflux‐associated pyelonephritis and subsequent parenchymal scarring and is traditionally depicted by fluoroscopic VCUG. This case series describes the phenomenon of IRR occurring in association with VUR in 4 children as depicted by contrast‐enhanced voiding urosonography. The ability of contrast‐enhanced voiding urosonography to show IRR when it occurs in conjunction with VUR compares favorably to that of fluoroscopic VCUG.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Intrarenal Reflux

Colleran

Barnewolt

Chow

et al. 2016

J of Ultrasound Medicine

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“…In contrast, Boubnova et al . reported that high‐grade reflux with IRR is not different from high‐grade reflux without IRR in terms of frequency of UTI, stability of renal status at DMSA scan and spontaneous resolution after medical treatment during 3 years of follow up . They concluded that the presence of IRR does not justify more aggressive management than that provided for high‐grade reflux without IRR.…”

Section: Discussionmentioning

confidence: 99%

Intrarenal reflux in primary vesicoureteral reflux

Fukui¹,

Watanabe²,

Yoshino³

2012

Int J of Urology

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Abbreviations & AcronymsObjectives: To elucidate the significance of intrarenal reflux. Methods: We retrospectively analyzed 276 patients (age <5 years) with grade III to V vesicoureteral reflux. They were divided into two groups: 55 patients with intrarenal reflux and 221 patients without intrarenal reflux (control group). All patients received low-dose antibiotic prophylaxis. Results: The most common initial presentation in both groups was febrile urinary tract infection. On dimercaptosuccinic acid scan, the rate of decreased differential renal function (<40%) was significantly higher in the intrarenal reflux group than in the control group (51% vs 33%, P < 0.05). Breakthrough urinary tract infections were observed in 26 patients (47%) in the intrarenal reflux group and 61 patients (28%) in the control group (P < 0.01). There was no statistically significant difference regarding spontaneous resolution of reflux, which occurred in nine patients (16%) in the intrarenal reflux group and 32 patients (14%) in the control group. Surgical treatment was selected more often in the intrarenal reflux group (P < 0.05) because of the high incidence of breakthrough urinary tract infection. Conclusions:The rate of spontaneous resolution of high-grade vesicoureteral reflux is similar between patients with and without intrarenal reflux. However, those with intrarenal reflux present are more likely to present a decreased differential renal function and breakthrough urinary tract infections. Consequently, surgical treatment is considered more frequently in cases with intrarenal reflux. Although high-grade vesicoureteral reflux with intrarenal reflux can be treated conservatively, physicians should take into account the higher risk of breakthrough urinary tract infections.

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“…IRR tedavisi halen tartışmalıdır. Baubrova ve arkadaşları [8], IRR'si olan hastalar ile IRR'si olmayan yüksek dereceli reflü hastalarını tekrarlayan İYE sıklığı açısından karşılaştırmışlar ve arasında herhangi bir fark saptamamışlardır. Araştırmacılar medikal tedavi sonrası kendiliğinden düzelme oranlarının aynı olduğunu da 3 yıllık takiplerinde ispatlamışlardır.…”

Section: Discussionunclassified

İntrarenal Reflü

YILMAZ

Yüksel

2019

Pamukkale Medical Journal

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ÖzetVezikoüreteral reflü (VUR), idrarın mesaneden böbreklere üreter yoluyla geri aktığı durum olarak adlandırılır. İntrarenal reflü (IRR), idrarın böbrek pelvisinden toplayıcı kanallar içine doğru geri kaçması (idrarın piyelotubuler geri akımı) olarak tanımlanır. IRR genellikle yüksek dereceli VUR ile birlikte bulunur. Bu olgu sunumunda yüksek dereceli VUR'u ve ona eşlik eden IRR'si olan bir erkek çocuk sunulmuştur. Hasta 2 yıllık izleminde antibiyotik profilaksisi kullanmamış, IRR'si kendiliğinden düzelirken VUR'u da gerilemiştir. VUR'lu hastalardaki IRR insidansı %2 ile %10 arasında bildirilmektedir. Yüksek dereceli VUR'un spontan düzeldiği bilindiğinden, IRR'nin eşlik ettiği yüksek dereceli VUR'ların düşük doz antibiyotik proflaksisi ile izlenmesi önerilmektedir. Çünkü IRR var olsa bile ateşli idrar yolu enfeksiyonu (İYE) olmadığı sürece prognozun fazlaca etkilenmediği belirlenmiştir. Hastada antibiyotik profilaksisi kullanılamamış ve takip döneminde hasta 2 kez İYE geçirmiştir. Buna rağmen IRR kaybolmuş, VUR derecesi belirgin olarak gerilemiştir. IRR ile birlikte böbrekte hasar riski artar. Bu nedenle IRR varlığı yüksek dereceli VUR'lu bebekler ve yeni doğanlarda daha dikkatle değerlendirilmelidir.Anahtar Kelimeler: Veziko-üreteral reflü, skar, renal papilla, profilaksi.Yılmaz N, Yüksel S. İntrarenal reflü. Pam Tıp Derg 2019;12:347-350. AbstractVesicoureteral reflux (VUR) is called a condition in which urine flows backward from the bladder to the kidneys via ureters. Intrarenal reflux (IRR) is defined as the urine back flow from the renal pelvis into the collecting ducts (pyelo-tubular backflow). IRR is usually associated with high-grade VUR. In this case report, a male infant with high-grade VUR associated with IRR was presented. During the 2-year follow-up, he did not use antibiotic prophylaxis, and his IRR improved spontaneously and VUR regressed. Incidence of IRR in patients with VUR is reported between 2% and 10%. Since the high-grade VUR is known to spontaneously recover, it is recommended that high degree VUR associated IRR should be followed with low-dose antibiotic prophylaxis. Because, even if there is an IRR, many studies are reported that the prognosis cannot be affected, if there is no febrile urinary tract infection. The patient could not use antibiotic prophylaxis, and urinary tract infections occurred two times during the follow-up period. However, IRR was disappeared, and the degree of VUR decreased significantly. The risk of scarring in the kidney increases with the presence of IRR. Therefore, the presence of IRR should be evaluated more carefully in infants and neonates with high-grade VUR.

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Evolution and prognosis value of intrarenal reflux

Cited by 17 publications

References 26 publications

Intrarenal Reflux

Intrarenal Reflux

Intrarenal reflux in primary vesicoureteral reflux

İntrarenal Reflü

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