Reliability of Sonography for the Prediction of Vesicoureteral Reflux in Children With Mild Hydronephrosis

2021 ◽  
pp. 875647932199064
Author(s):  
Ehsan Valavi ◽  
Azar Nickavar ◽  
Mohammad Parsamanesh
Keyword(s):  
Vesicoureteral Reflux ◽  
Study Design ◽  
Reliable Method ◽  
Low Grade ◽  
Antenatal Hydronephrosis ◽  
Renal Sonography

Objectives: Postnatal evaluation of vesicoureteral reflux (VUR) remains controversial in patients with antenatal hydronephrosis (HN). The objective of this study was to identify the significance of mild postnatal HN as a marker of VUR and its severity. Materials and Methods: Sonographic findings of 248 children (351 kidneys) with persistent postnatal HN were evaluated for the incidence and severity of primary VUR. Results: The majority of patients had mild (67.8%) HN, followed by moderate (27.6%) and severe (4.6%) HN. VUR was identified in 14.7% of patients with mild HN, 18.5% of patients with moderate HN, and 18.7% of patients with severe HN. About 11.44% of patients with mild HN had low-grade VUR, followed by moderate (45.71 %) and severe grades (42.85%). Conclusion: A large number (89%) of patients with mild HN had moderate to severe VUR. In this cohort, renal sonography was not a reliable method for the prediction of VUR and its severity in patients with mild postnatal HN. However, it was reliable for high grades of VUR. These results are limited due to the study design and the inability to generalize these findings. These results should be replicated across other multiple clinics, thereby recruiting more variety of patients, to validate these study recommendations.

Postoperative Cystography and Endoscopic Treatment of Low-Grade Vesicoureteral Reflux

2008 ◽  
Vol 18 (3) ◽  
pp. 461-463 ◽  
Author(s):  
Luke Harper ◽  
Stefania Boutchkova ◽  
Frederic Lavrand ◽  
Pierre Vergnes ◽  
Francois Semjen ◽  
...  
Keyword(s):  
Vesicoureteral Reflux ◽  
Endoscopic Treatment ◽  
Low Grade

scholarly journals Antibiotic Prophylaxis for Children with Primary Vesicoureteral Reflux: Where Do We Stand Today?

2008 ◽  
Vol 2008 ◽  
pp. 1-5 ◽  
Author(s):  
Michiel Costers ◽  
Rita Van Damme-Lombaerts ◽  
Elena Levtchenko ◽  
Guy Bogaert
Keyword(s):  
Antibiotic Prophylaxis ◽  
Vesicoureteral Reflux ◽  
Renal Damage ◽  
Low Grade ◽  
Urogenital System ◽  
Recurrent Utis ◽  
School Aged Children ◽  
Tract Infections ◽  
American Urological Association

The main goal of the management of vesicoureteral reflux (VUR) is prevention of recurrent urinary tract infections (UTIs), and thereby prevention of renal parenchymal damage possibly ensuing from these infections. Long-term antibiotic prophylaxis is common practice in the management of children with VUR, as recommended in 1997 in the guidelines of the American Urological Association. We performed a systematic review to ascertain whether antibiotics can be safely discontinued in children with VUR and whether prophylaxis is effective in the prevention of recurrent UTIs and renal damage in these patients. Several uncontrolled studies indicate that antibiotic prophylaxis can be discontinued in a subset of patients, that is, school-aged children with low-grade VUR, normal voiding patterns, kidneys without hydronephrosis or scars, and normal anatomy of the urogenital system. Furthermore, a few recent randomized controlled trials suggest that antibiotic prophylaxis offers no advantage over intermittent antibiotic therapy of UTIs in terms of prevention of recurrent UTIs or new renal damage.

scholarly journals Renal scintigraphy in infants with antenatally diagnosed renal pelvis dilatation

2008 ◽  
Vol 65 (4) ◽  
pp. 299-302
Author(s):  
Boris Ajdinovic ◽  
Ljiljana Jaukovic ◽  
Amira Peco-Antic ◽  
Sanja Dugonjic
Keyword(s):  
Renal Function ◽  
Vesicoureteral Reflux ◽  
Ureteropelvic Junction Obstruction ◽  
No Reduction ◽  
Renal Scintigraphy ◽  
Newborn Period ◽  
Antenatal Hydronephrosis ◽  
Differential Renal Function ◽  
Renal Pelvis Dilatation

Background/Aim. Ureteropelvic junction obstruction and vesicoureteral reflux are the most frequent entities identified on the basis of antenatal hydronephrosis. The aim of this study was to determine the incidence and pattern of abnormal renal scintigraphy findings in postnatal investigation of children with antenatal hydronephrosis. Methods. Twenty four infants (19 boys and five girls) presented with antenatal hydronephrosis and mild to moderate hydronephrosis on ultrasound in newborn period were referred for renal scintigraphy. Ten patients with vesicoureteral reflux documented on micturating cystoureterography underwent 99mTc-DMSA renal scintigraphy and 14 patients were subjected to 99mTc-DTPA scintigraphy. Results. Anteroposterior pelvic diameter on ultrasound ranged from 11 to 24 mm. Renal DMSA scans identified congenital scars in two boys with bilateral reflux of grade V and unilateral reflux of grade III. Relative kidney uptake (RKU) less than 40% was found in three, and poor kidney function (RKU less than 10%) in two patients. Significant obstruction was shown on DTPA diuretic renal scintigraphy in 6/14 patients. Some slowing in dranaige (T1/2 greater than 10 minutes) with no reduction in differential renal function was identified in three patients. Differential renal function less than 10% was obtained in one case. Conclusion. A high percent of abnormal renal scintigraphy findings was obtained. Renal scintigraphy was useful in determination of underlying cause of antenatally detected hydronephrosis.

Low-grade Vesicoureteral Reflux Variability in Grade on Sequential Radiographic and Nuclear Cystograms

1991 ◽  
Vol 16 (4) ◽  
pp. 243-246 ◽  
Author(s):  
MICHAEL J. GELFAND ◽  
JANET L. STRIFE ◽  
VICTORIA S. HERTZBERG
Keyword(s):  
Vesicoureteral Reflux ◽  
Low Grade

Prediction of High-grade Vesicoureteral Reflux in Children Younger Than 2 Years Using Renal Sonography

2016 ◽  
Vol 35 (4) ◽  
pp. 761-765 ◽  
Author(s):  
Sun Kyoung You ◽  
Jong Chun Kim ◽  
Won Hong Park ◽  
So Mi Lee ◽  
Hyun-Hae Cho
Keyword(s):  
Vesicoureteral Reflux ◽  
High Grade ◽  
Renal Sonography

THE NATURAL HISTORY OF NEONATAL VESICOURETERAL REFLUX ASSOCIATED WITH ANTENATAL HYDRONEPHROSIS

2000 ◽  
pp. 1057-1060 ◽  
Author(s):  
WALID FARHAT ◽  
GORDON McLORIE ◽  
DENIS GEARY ◽  
GIANPAOLO CAPOLICCHIO ◽  
DARIUS B??GLI ◽  
...  
Keyword(s):  
Natural History ◽  
Vesicoureteral Reflux ◽  
Antenatal Hydronephrosis ◽  
History Of

scholarly journals The role of voiding cystourethrography in the investigation of children with urinary tract infections

2016 ◽  
Vol 10 (5-6) ◽  
pp. 210 ◽  
Author(s):  
Linda C. Lee ◽  
Armando J. Lorenzo ◽  
Martin A. Koyle
Keyword(s):  
Urinary Tract ◽  
Vesicoureteral Reflux ◽  
Urinary Tract Infections ◽  
Renal Scarring ◽  
High Rate ◽  
Voiding Cystourethrography ◽  
Low Grade ◽  
Endoscopic Injection ◽  
Febrile Uti ◽  
Tract Infections

Urinary tract infections (UTIs) represent a common bacterial cause of febrile illness in children. Of children presenting with a febrile UTI, 25‒40% are found to have vesicoureteral reflux (VUR). Historically, the concern regarding VUR was that it could lead to recurrent pyelonephritis, renal scarring, hypertension, and chronic kidney disease. As a result, many children underwent invasive surgical procedures to correct VUR. We now know that many cases of VUR are low-grade and have a high rate of spontaneous resolution. The roles of surveillance, antibiotic prophylaxis, endoscopic injection, and ureteral reimplantation surgery also continue to evolve. In turn, these factors have influenced the investigation of febrile UTIs.Voiding cystourethrography (VCUG) is the radiographic test of choice to diagnose VUR. Due to its invasive nature and questionable benefit in many cases, the American Academy of Pediatrics (AAP) no longer recommends VCUG routinely after an initial febrile UTI. Nevertheless, these guidelines pre-date the landmark Randomized Intervention of Children with Vesicoureteral Reflux (RIVUR) trial and there continues to be controversy regarding the diagnosis and management of VUR. This paper discusses the current literature regarding radiographic testing in children with febrile UTIs and presents a practical risk-based approach for deciding when to obtain a VCUG.

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