Factors Related to the Resolution of Primary Vesicoureteral Reflux

Jung, Jae-Won; Woo, Mi-Kyoung; Koo, Ja-Wook

doi:2009.13.1.40

J Korean Soc Pediatr Nephrol > Volume 13(1); 2009 > Article

J Korean Soc Pediatr Nephrol 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

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