Vesicoureteral Reflux and Renal Scarring in Children

Mattoo, Tej K.; Mathews, Ranjiv; Gupta, Indra R.

doi:10.1007/978-3-662-43596-0_50

Cited by 3 publications

(3 citation statements)

References 330 publications

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“…Symptomatic UTIs in children present as unexplained fever ≥ 38℃, abnormal urinalysis results such as pyuria, and confirmed diagnosis of significant bacteriuria of ≥10 5 colony forming units of bacteria per milliliter (CFU/mL) in one urine specimen 13) .…”

Section: Methodsmentioning

confidence: 85%

“…UTIs are known to present many risk factors, especially vesicoureteral reflux (VUR), which is a common malformation found in approximately 30% of young females with UTIs 4) . VUR can cause recurrent UTIs as well as damage and scarring of the kidneys, which can lead to reflux nephropathy 5,6) . Therefore, early diagnosis and treatment of VUR is critical for a better outcome 7) .…”

Section: Introductionmentioning

confidence: 99%

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Predictive Markers for Screening Renal Damage in Children with Urinary Tract infections and Vesicoureteral Reflux

et al. 2020

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Purpose: Urinary tract infections (UTIs) are the most common and serious bacterial infections in children. Therefore, early diagnosis of vesicoureteral reflux (VUR) for treatment planning and the identification of noninvasive markers that can predict renal injury are important in patients with UTIs. We analyzed the clinical features of pediatric UTIs commonly encountered by general practitioners and reinterpreted the blood tests and imaging findings to identify the important clinical predictive markers of VUR in order to selectively perform VCUG. Methods: This retrospective study was performed among 183 children diagnosed with a UTI or acute pyelonephritis. Results: The most significant predictor of high grade and bilateral VUR identified using area under the curve analyses was hydronephrosis on kidney ultrasound images with renal cortical defects on dimercaptosuccinic acid (DMSA) kidney scan simultaneously, followed by hydronephrosis only on kidney ultrasound. Conclusion: The presence of hydronephrosis on kidney ultrasound images or cortical defects or asymmetric kidneys on the DMSA kidney scans can be predictive markers of VUR, reducing the need for VCUG. Our study can thus help minimize the exposure to radiation among patients through selective VCUG.

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Section: Methodsmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Predictive Markers for Screening Renal Damage in Children with Urinary Tract infections and Vesicoureteral Reflux

et al. 2020

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“…The prevalence of VUR varies from 1.3% of healthy children to 8%-50% of children with urinary tract infection. [4] X-ray voiding cystourethrography is gold standard for diagnosis. Early diagnosis and intervention may help to prevent from renal scars.…”

Section: Discussionmentioning

confidence: 99%

Comparative study of conventional urosonography without contrast enhancement and x-ray voiding cystourethrography for diagnosis of vesicoureteral reflux in children

Gülleroğlu

Gulleroglu

Baskın

2021

DCC

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Background: Vesicoureteral reflux is the most common urinary congenital anomaly in children. Given the risk associated with radiation exposure there has been an increasing need for radiation-free method in the diagnosis and follow-up of the vesicoureteral reflux. The aim of our study is to compare conventional urosonography without contrast enhancement and x-ray voiding cystourethrography.Patients and Methods: Children with recurrent urinary tract infection with suspected vesicoureteral reflux were included to the study. Vesicoureteral reflux is demonstrated and graded by x-ray voiding cystourethrography. DMSA is used for the evaluation of renal scar. Conventional sonographic procedure was performed in all patients. Ureterovesical junction insertion angle was evaluated. The diameter and length of the ureterovesical junction were also measured.Results: 268 children enrolled to the study. Vesicoureteral reflux was demonstrated in 62 children by x-ray voiding cystourethrography. Ureterovesical junction insertion angle measurement had a statistically significant relation for right and left vesicoureteral reflux presence (right: r: .646, p: .01 and left: r: .446, p: .01). Diagnosis sensitivity of vesicoureteral reflux with conventional ultrasonography is 95.10% and specificity is 81% (Youden’s index 76.1%) for the cutoff value of the ureterovesical junction insertion angle is 28.6 degrees. Positive predictive value is 87.2%, negative predictive value is 94.73% and diagnostic accuracy is 86.29% with conventional ultrasonography.Conclusions: Measurement of ureterovesical junction insertion angle, length and diameter by conventional urosonography is an easy accessible and cheap technique with high sensitivity and specificity for the diagnosis and followup of the vesicoureteral reflux without exposure to ionizing radiation.

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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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Vesicoureteral Reflux and Renal Scarring in Children

Cited by 3 publications

References 330 publications

Predictive Markers for Screening Renal Damage in Children with Urinary Tract infections and Vesicoureteral Reflux

Predictive Markers for Screening Renal Damage in Children with Urinary Tract infections and Vesicoureteral Reflux

Comparative study of conventional urosonography without contrast enhancement and x-ray voiding cystourethrography for diagnosis of vesicoureteral reflux in children

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

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