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Journal of the Korean Society of Pediatric Nephrology 2009;13(1): 40-48. doi: https://doi.org/10.3339/jkspn.2009.13.1.40
요로감염 영아에서 일차성 방광요관역류
정재원, 우미경, 구자국
1인제대학교 의과대학 상계백병원 소아청소년과
2인제대학교 의과대학 상계백병원 소아청소년과
3인제대학교 의과대학 상계백병원 소아청소년과
Factors Related to the Resolution of Primary Vesicoureteral Reflux
Jae-Won Jung, Mi-Kyoung Woo, Ja-Wook Koo
1Department of Pediatrics, College of Medicine, Inje Unversity, Sanggye Paik Hospital
2Department of Pediatrics, College of Medicine, Inje Unversity, Sanggye Paik Hospital
3Department of Pediatrics, College of Medicine, Inje Unversity, Sanggye Paik Hospital
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ABSTRACT
Purpose : This study was performed to identify factors related to the resolution of primary vesicoureteral reflux (VUR) in infants.
Methods : We reviewed 183 infants (M : F=149 : 34) diagnosed as urinary tract infection (UTI) between February 2002 and July 2007 at Sanggye Paik Hospital. The diagnosis of UTI was made by culture from a urine specimen obtained by suprapubic puncture (n=97), catheterization (n=83), or collection bag method (n=3, twice positive culture of same organism). All of the infants were performed renal ultrasonography, DMSA scan and voiding cystourethrography (VCUG) study. Follow-up imaging consisted of contrast VCUG or direct isotope VCUG at interval of 1 year. We evaluated the relationship of clinical and laboratory finding, radiologic finding in infants with VUR.
Results : Among 51 VUR patients, 18 infants had grade I-II, 12 infants had grade III and the other 21 patients had grade IV-V. Abnormal findings including hydronephrosis on renal ultrasonography were not correlated with severity of VUR. However, the incidence of renal defect in the first DMSA scan showed a tendency of direct correlation with severity of VUR in female patients only (P<0.001). There was significant difference of resolution rate in three VUR groups (grade I-II, III, IV-V) in male patients only (P=0.025). Resolution rate was higher for male patients with unilateral VUR than bilateral (P<0.001). But unilaterality had not any affect on VUR resolution in female VUR patients (P=0.786). Resolution rate was higher for VUR patients without renal scar than VUR patients with renal scar (P<0.001).
Conclusion : According to our findings, grade of VUR, laterality and renal scar are the factors that contribute to resolution of primary VUR in male and female infants differently.
Key words: Vesicoureteral reflux | Urinary tract infection | Voiding cystourethrography | Infants
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