[42] Critical analysis of the outcome of primary unilateral vesico-ureteric reflux in a contemporary series
Objective: To explore the possible risk factors that affect the resolution rate in patients with primary unilateral vesico-ureteric reflux (VUR) under conservative treatment, as VUR is a common finding in the paediatric age group with the risk of repeated urinary tract infections and renal damage. M...
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| Formato: | article |
| Lenguaje: | EN |
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Taylor & Francis Group
2018
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/0f489646a3bd44c18b362132b6b9d6cf |
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| Sumario: | Objective: To explore the possible risk factors that affect the resolution rate in patients with primary unilateral vesico-ureteric reflux (VUR) under conservative treatment, as VUR is a common finding in the paediatric age group with the risk of repeated urinary tract infections and renal damage. Methods: We retrospectively evaluated all patients with VUR between 2006 and 2014, and only patients with primary unilateral VUR were included. Records were reviewed for: age at diagnosis, antenatal history, gender, mode of presentation, side and grade of VUR, associated hydronephrosis (HN), presence of scarring, and split function on dimercaptosuccinic acid (DMSA) scan. Clinical and radiological outcomes were assessed. Both uni- and multivariate analyses were conducted. Results: A total of 68 patients (32 boys and 36 girls) with primary unilateral VUR were included, with a mean age at diagnosis of 10 months. Antenatal HN was detected in 50% of the patients. VUR was high grade (IV–V) in 22 patients (32%). Associated HN was evident in 39 patients (57%). DMSA scans showed renal scarring in 16 patients (23%) and a mean split function of 47%. After a mean follow-up of 7 years, VUR resolved in 49 patients (72%). VUR grade, DMSA split function, and associated high-grade HN were significant predictors of VUR resolution. On multivariate analysis, the presence of high-grade HN with VUR was the only significant independent risk factor. Conclusion: The resolution rate in primary unilateral VUR under conservative treatment is significantly affected by the grade of VUR, split renal function on DMSA, and presence of high-grade HN. Association of high-grade HN with VUR carries a low chance for spontaneous resolution. |
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