Risk factors for renal scarring in children and adolescents with lower urinary tract dysfunction

Abstract

Risk factors for renal scarring in children with lower urinary tract dysfunction (LUTD) were evaluated. The medical records of 120 patients were assessed concerning gender, presence of vesicoureteric reflux (VUR), bladder capacity, detrusor overactivity, residual urine, febrile urinary tract infection (UTI), bacteriuria, constipation, detrusor sphincter incoordination (DSI), high detrusor pressure at maximal cystometric capacity (PMCC), low compliance, and thickness and trabeculation of the bladder wall. Renal scarring was diagnosed by (99m)technetium-dimercaptosuccinic acid renal scan (DMSA). Renal scarring was detected in 38 patients (31%). VUR, UTI, decreased bladder capacity, urinary residue, and trabeculated and thick bladder wall were associated with scarring at univariate analysis. Multivariate analysis showed VUR (P < 0.0001) as the independent risk factor for renal scarring. Thickness of the bladder wall was a marginal risk factor (P = 0.07). Although UTI was not a risk factor, it was associated with VUR (P = 0.03). In our analysis, VUR was the main risk factor; however, renal scarring was probably due to multifactorial causes, as VUR was associated with UTI.

Alt üriner sistem işlev bozukluğu bulunan çocuklarda ürodinami ve ultrasonografi bulgularının karşılaştırılması

“…Vesicoureteral reflux is observed in approximately 20-50% of children with lower urinary system dysfunction (10). In the study performed by Leonardo et al (11), this rate was found to be 25% and it was found that the possibility of development of renal scar was four fold higher in these children. In children in whom clinical improvement could not be provided after antireflux surgery, accompanying lower urinary system dysfunction should be investigated (12,13).…”

“…Lower urinary system dysfunction not treated successfully has been reported to be one of the most important causes of recurring urinary tract infection (5-7). The relation of lower urinary system dysfunction and vesicouretheral reflux (VUR) has been studied in many studies (8)(9)(10)(11). Primary VUR is the most common form and is caused by proceeding of distal ureters in a short mucosal tunnel.…”

Analysis of the permanent renal injury risk factors in congenital neuropathic bladder

“…Leanardo ve ark. (10) alt üriner sistem disfonksiyonu olan çocuklarda yaptığı bir çalışmada VUR eşlik etmediği sürece İYE ataklarının böbrek hasarına yol açmadı-ğını göstererek bu tedavi yaklaşımını desteklediler. Ayrıca VUR olmaksızın ve klinik bulguların eşlik etmediği semptomsuz bakteriurinin böbrek hasarı için bir risk faktör olmadığı da bildirilmiştir (11) .…”

Population-based survey of the prevalence of lower urinary tract symptoms in adolescents with and without psychotropic substance abuse

“…In children, the association of LUTS with urinary tract infection, persistent vesicoureteric reflux, renal scarring, and constipation have drawn substantial attention over the years. 3,4 Among various LUTSs, urinary incontinence (UI) has been most extensively investigated in children with the reported prevalence varying from 1.8% to ORIGINAL ARTICLE abuse increased the odds for lower urinary tract symptoms. Non-ketamine substance users and ketamine users were respectively 2.8-fold (95% confidence interval, 2.0-3.9) and 6.2-fold (4.1-9.1) more likely than control subjects to develop lower urinary tract symptoms.…”