Imaging strategies for vesicoureteral reflux diagnosis

Stefanidis, Constantinos J.; Siomou, Ekaterini

doi:10.1007/s00467-006-0396-8

Cited by 43 publications

(24 citation statements)

References 92 publications

(125 reference statements)

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“…Dick PT and Feldman W in an evaluation of 434 publications through a systematic overview concluded that the current recommendations are not based on firm evidence (10). Many authors have to find a better way for detecting VUR and reduce invasiveness of the procedures (11)(12)(13)(14). We found evidence for extensive efforts in the medical literature trying to diagnose VUR without radiation and catheterization.…”

Section: Imaging Studiesmentioning

confidence: 84%

Diagnostic challenges in Urinary Tract Infections in Children

Sharifian

2015

Arch Pediatr Infect Dis

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Context: Urinary tract infections (UTIs) are among the most common infections in children that affect up to 3% of boys and 8% of girls. Delay in diagnosis and treatment causes renal injury and scars that can progress to end stage renal disease (ESRD) requiring dialysis and transplantation. Results: There are many pitfalls in diagnosis of UTIs both with urinalysis and culture methods and also in evaluating the risk factors and causes of UTIs. Conclusions: This paper reviews and discusses the common pitfalls in diagnosis and evaluation of UTIs in children.

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Section: Imaging Studiesmentioning

confidence: 84%

Diagnostic challenges in Urinary Tract Infections in Children

Sharifian

2015

Arch Pediatr Infect Dis

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“…Some studies have reported that renal damage is associated with high-grade VUR without urinary tract infection (17), whereas others have reported that VUR does not cause renal scarring in the absence of urinary tract infection (18). The small number of patients and refluxing units in our study might obscure the possible association between the new quantitative parameters and renal and patient outcome.…”

Section: Discussionmentioning

confidence: 69%

New Quantitative Parameters for Evaluating Radionuclide Cystography and Their Value in Understanding the Physiology of Reflux

Özdoğan

Türkmen²,

Atasever³

et al. 2009

Journal of Nuclear Medicine Technology

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In this descriptive study of radionuclide cystography, timeactivity curves were generated from renal pelves with reflux and evaluated to reveal the physiology of the reflux. The generated new parameters were also evaluated for any correlation with the frequency of urinary tract infections and renal scarring. Methods: Thirty-two children with reflux to the renal pelvis (36 refluxing units) were included. Regions of interest were drawn on the pelves and bladder, and time-activity curves were generated. The first reflux phase, the bladder volume at first reflux, and the bladder volume at maximal reflux were defined, and reflux percentages were calculated. Dimercaptosuccinic acid (DMSA) scintigraphy findings and urinary tract infections were used for correlation. Results: New curves from the renal pelvis during bladder filling and bladder emptying were generated and their patterns classified. Episodic reflux to the pelvis was observed on time-activity curves, which demonstrated 4 different emptying patterns during voiding. These patterns were described in detail. Visually, residual activity was present in the renal pelves in 58.8% of patients. The mean number of urinary tract infections per year was 1.07 (range, 0-4; SD, 0.88). The DMSA findings were normal in 57.1% of the patients. Conclusion: We obtained and categorized some new time-activity curve patterns from renal pelves with reflux on radionuclide cystography. Discussing these patterns may help physicians understand the physiology of the reflux and the relationship between infections and reflux. Vesi coureteral reflux (VUR) is a predisposing factor for urinary tract infection (1), and up to 20%240% of patients with urinary tract infection have been shown to have reflux (2-4). The causes of renal scarring are multifactorial, and VUR has been declared to be one of the main risk factors (5). Early diagnosis of VUR and urinary tract infection is necessary to decrease renal scarring (3). VUR may result in hypertension and end-stage renal disease (3,6,7). The correlation between renal scarring and VUR has been shown to vary between 23% and 75% and is higher in patients with a high grade of VUR (8-11). The prevalence of renal damage is higher in patients with severe reflux (7,12,13). Therefore, children with high grades of VUR must be carefully managed, treated, and followed up to achieve a better outcome in adulthood (3).Radionuclide cystography, the preferred procedure for the follow-up of patients with VUR, allows continuous acquisitions and exposes patients to less radiation than does voiding cystourethrography (14).Some information that can be obtained from radionuclide cystography has been shown to correlate with prognosis. In one study, urinary bladder volume and pressure at reflux were prognostic for the resolution of reflux (13); in another, reflux at low bladder volumes was associated with increased renal scarring (7). The ability to predict the prognosis for a particular patient at the time of diagnosis may lead to better treatment decisions and follow-up...

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“…Genellikle süt çocukluğundan sonra tanı alırlar. Üriner enfeksiyon geçirmek sekonder renal skar gelişmesi için önemli bir risk faktörüdür (52).…”

Section: Reflü Nefropatisiunclassified

Renal Parenchymal Scarring and Reflux Nephropathy

Gökçe¹,

Alpay²

2012

Turk Neph Dial Transpl

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Vezikoüreteral reflü (VUR), üreterin mesane içine giriş yerinin yetersizliği sonucu idrarın mesaneden üreterlere ve renal toplayıcı sisteme geriye kaçışını ifade eder. Vezikoüreteral reflü bakterilerin mesaneden üst üriner sisteme taşınmasını sağlayarak piyelonefrite yol açabilir. Piyelonefrit sırasında oluşan yangı bir veya her iki böbrekte renal parenkimal hasar (RPS) olarak adlandırılan kalıcı zedelenmeye neden olabilir. Günümüzde RPS tanısı için kullanılan yöntem statik kortikal renal sintigrafidir, teknesyum-99m-dimerkaptosüksinik asit kullanılarak yapılır. Vezikoüreteral reflünün uzun dönem komplikasyonu nefropatidir. Reflü nefropatisi (RN), VUR'a ikincil olarak gelişen RPS oluşumu ve böbrek fonksiyonlarında bozulmayı ifade eder. Hipertansiyon, proteinüri, kronik böbrek hastalığı ve son dönem böbrek hastalığı RN'nin iyi bilinen uzun dönemdeki komplikasyonlarıdır. Biz bu derlememizde ülkemizde ve gelişmekte olan ülkelerde halen büyük bir morbidite nedeni olan RN'ne dikkatleri çekmek istedik.anaHtaR sÖzcÜKLeR: Vezikoüreteral reflü, Renal skar, Reflü nefropatisi, Hipertansiyon abstRact Vesicoureteral reflux (VUR) is the abnormal flow of urine from the bladder into the upper urinary tract. In the majority of cases, it occurs as a result of a primary maturation abnormality of the vesicoureteral junction. When VUR is associated with bacteriuria, the possibility of pyelonephritis with subsequent renal scars increases, theoretically as a result of bacteria being more readily conveyed to the renal parenchyma. The ultimate evaluation for renal scars is done through a cortical renal scan using technetium-99 labeled dimercaptosuccinic acid. The long term complication of VUR is nephropathy. Reflux nephropathy (RN) is defined as the formation of renal parenchymal scarring and renal function impairment induced by VUR. Hypertension, proteinuria, chronic kidney disease and end stage renal failure are well-recognized sequelae of renal scars. In this review we tried to emphasize the importance of RN which is stil a significant cause of morbidity especially in developing countries.

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Imaging strategies for vesicoureteral reflux diagnosis

Cited by 43 publications

References 92 publications

Diagnostic challenges in Urinary Tract Infections in Children

Diagnostic challenges in Urinary Tract Infections in Children

New Quantitative Parameters for Evaluating Radionuclide Cystography and Their Value in Understanding the Physiology of Reflux

Renal Parenchymal Scarring and Reflux Nephropathy

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