Intrarenal reflux in primary vesicoureteral reflux

Fukui, Shinji; Watanabe, Masahiro; Yoshino, K.

doi:10.1111/iju.12015

Cited by 13 publications

(17 citation statements)

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“…Moreover, IRR tends to form parenchymal scars in 26-65% of cases over time (5,10,11). Boubnova et al found that the possibility for the breakthrough of urinary tract infections during long-term antibiotic prophylaxis is the same in the group of patients with high grade of VUR and IRR as in those with high-grade VUR but without IRR, whereas some other authors confirmed that patients with IRR had significantly more breakthrough infections than those without IRR (12,13). It seems that IRR is equally distributed in both genders and that it is present only in patients with higher grades of VURs (III, IV, and V grade), while it has not been observed in patients with lower grades of VURs (grades I and II) on VCUG (9).…”

Section: Introductionmentioning

confidence: 99%

Intrarenal Reflux in the Light of Contrast-Enhanced Voiding Urosonography

et al. 2021

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Purpose: The aim of this study was to analyze the incidence of intrarenal reflux (IRR) among vesicoureteral refluxes (VURs), diagnosed by contrast-enhanced voiding urosonography (ceVUS), to define VURs which are positive to IRR and their locations in the kidney.Materials and Methods: Seventy patients with VURs, including 103 uretero-renal units (URUs) with VURs of grades II–V (37 URUs were excluded because of renal anomalies or absence of VUR) were examined with ceVUS due to recurrent febrile UTI or first febrile UTI accompanied by abnormalities on renal ultrasonography. Patients were examined on GE Logiq S8 ultrasound machine, using second generation of ultrasound contrast agent.Results: Out of 103 VURs, 51 (49.51%) had IRR regardless the grade of VUR, showing increase in IRR incidence with VUR severity (p < 0.0001). The median age at the time of IRR diagnosis was 5 months (IQR, 3–14.3), whereas in patients without IRR, it was 15.5 months (IQR, 5–41.5), (p = 0.0069). IRR was most common in superior pole (80%), followed by inferior pole (62.7%), and middle segments (37%), and to all segments (27%) (p < 0.0001).Conclusion: In the present study, patients with IRR-associated VUR showed earlier clinical presentation. The distribution of IRRs corresponded to the natural distribution of composed papillae types II and III, while the incidence of IRR increased with severity of VUR. Further clinical studies may point to the importance of considering IRR in the future classification of VUR.

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Section: Introductionmentioning

confidence: 99%

Intrarenal Reflux in the Light of Contrast-Enhanced Voiding Urosonography

et al. 2021

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“…VUR is the most common congenital urinary tract abnormality in children that usually presents with urinary tract infection (UTI) [2]. It is conventionally diagnosed and followed by voiding cystourethrogram (VCUG) that classifies the disease into five grades (I to V) [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Children with VUR are in the danger of frequent pyelonephritis that may lead to the development of kidney scare and progressive kidney dysfunction [5][6][7][8]. When associated with intrarenal reflux, it decreases the renal function, and increases UTI incidence [4,5]. VUR may also resolve spontaneously [3], but complications may occur even after resolution of VUR [6,7].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Procalcitonin Serum Levels in Children Younger than Five Years Old with Urinary Tract Infection

Sepahi

Moslemi

Haeri

2020

AJPR

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Background: Children with vesicoureteral reflux (VUR) are posed to the danger of recurrent pyelonephritis, kidney scar and renal failure. Nowadays, the evaluation of VUR is carried out using different imaging methods that are accompanied with different limitations. Pediatricians usually look for other evaluation methods that are feasible, easy to implement and carries the least amount of danger to the patient. Objectives: The aim of this study was to investigate the level of serum Procalcitonin (PCT) as a predictor of VUR instead of the voiding cystourethrogram (VCUG). Methods: This case-control study was conducted from 2013 to 2014. One hundred and ten children younger than five years old were divided into two groups: (i) the case group with 76 children diagnosed with urinary tract infection (UTI) using urine culture test, and (ii) the control group with 34 healthy children. Serum levels of PCT were measured by a commercial kit. Demographic data were collected using a questionnaire and analyzed by software SPSS. Results: Of the samples, 69.1% of them had no VUR, 20% and 10.9% of the samples suffered from severe unilateral VUR and severe bilateral VUR, respectively. With regard to the level of serum PCT, 61.8% of the samples were positive. One-half of those samples (38 people) who was diagnosed to be healthy had a normal level of serum PCT. However, 30 people (88.2%) of the samples diagnosed to be healthy using VCUG had increased level of serum PCT. The positive and negative predictive values of the level of serum PCT were 44% and 90%, respectively. In this respect, 50% of the samples diagnosed by using level of serum PCT were false positive and 11.8% were false negative. The kappa score for the level of serum PCT was 0.3 (P < 0.0001). The positive predictive value of the serum level of PCT for the female and male samples were 43% and 50% respectively. Conclusions: There was no statistically significant relationship between VUR and the serum level of PCT.

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“…3), den Refluxgrad mit oder ohne intrarenalem Reflux, einesoweit beurteilbarkonkomittante Blasenfunktionsstörung und der Präputialstatus des männlichen Säuglings [30]. Der intrarenale Reflux in Zusammenhang mit dilatierendem VUR (III-IV) sowie nachgewiesene Parenchymdefekte im DMSA-Scan stellen unabhängige Risikofaktoren für Durchbruchsinfekte wie weitere Parenchymschädigungen dar [31] (▶ Abb. 4).…”

Section: Introductionunclassified

Antirefluxoperation im ersten Lebensjahr, wenn ja, wann und wie? − Pro OP

Oswald

2019

Aktuel Urol

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ZusammenfassungEine offene chirurgische Intervention im ersten Lebensjahr bei Kindern mit VUR ist nur in Ausnahmefällen indiziert. V. a. männliche Säuglinge mit hochgradigem Reflux, Einschränkung der Nierenfunktion im Sinne einer Refluxnephropathie, eindeutiger infravesikaler Obstruktion, fieberhaften Durchbruchsinfekten im Sinne von Pyelonephritiden oder septischen Zustandsbildern bedürfen einer frühzeitigen chirurgischen Intervention. Diese beschränkt sich neben der zu empfehlenden Zirkumzision meist auf die endoskopische infravesikale Desobstruktion von Urethralklappen, prolabierenden Ureterozelen sowie sekundären Blasenhalsobstruktionen. Eine endoskopische Refluxtherapie mit Hyaluronsäure/Dextranomer ist lediglich als „down-staging“ des VUR aufzufassen, sie muss individuell indiziert werden, eine offene, suprapubische Entlastung des Harntraktes im Sinne einer Vesikostomie oder Ureterocutaneostomie ist nur mehr in Einzelfällen bei septischen Zuständen oder nicht durchführbarer endoskopischer Therapie berechtigt.

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Intrarenal reflux in primary vesicoureteral reflux

Cited by 13 publications

References 13 publications

Intrarenal Reflux in the Light of Contrast-Enhanced Voiding Urosonography

Intrarenal Reflux in the Light of Contrast-Enhanced Voiding Urosonography

Evaluation of Procalcitonin Serum Levels in Children Younger than Five Years Old with Urinary Tract Infection

Antirefluxoperation im ersten Lebensjahr, wenn ja, wann und wie? − Pro OP

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