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

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.