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The Occurrence of Renal Scarring in Children with nilateral Vesicoureteral Reflux

Korean Journal of Pediatrics 2005;48(9):998-1003.
Published online September 15, 2005.
The Occurrence of Renal Scarring in Children with nilateral Vesicoureteral Reflux
Tae Ho Lee, Mi Ran Son, Soon Ok Byun, Jung Woong Moon
Department of Pediatrics, Wallace Memorial Baptist Hospital, Busan, Korea
일측성 방광 요관 역류 환아에서 신반흔의 발생
이태호, 손미란, 변순옥, 문정웅
부산 왈레스기념 침례병원 소아과
Soon Ok Byun, Email: byunsmd@hanmail.net
: We evaluated the occurrence of renal scarring in children with unilateral vesicoureteral reflux(VUR), and the relationships between renal scar formation and risk factors such as VUR, duration of fever, acute-phase reactant, age, and sex.
: We retrospectively analyzed the data of 35 children newly diagnosed with unilateral vesicoureteral reflux after urinary tract infection(UTI) in Wallace Memorial Baptist Hospital between January 1996 and December 2004. Ultrasonography, Erythrocyte sedimentation rate(ESR), and C- reactive protein(CRP) were performed initially. Voiding cystourethrography(VCUG) was performed 1 to 3 weeks after treatment with UTI. 99mTc-dimercaptosuccinic acid(DMSA) scan was performed 4 to 6 months after treatment.
: Scintigraphic renal damage was present in 29 percent of the refluxing and in 3 percent of the nonrefluxing kidneys(P<0.05). The severity of VUR was significantly correlated with renal scar formation(P<0.05). The duration of fever before treatmen(5.0?.3 vs 2.6?.3) and prolonged fever of over 5 days were significantly different between renal scar group and non-renal scar group(P< 0.05). ESR(56.3?3.8 vs 27.9?8.1 mm/hr, P<0.05) and CRP(12.8?.3 vs 3.9?.8 mg/dL, P<0.05) at the diagnosis of UTI in the renal scar group were higher, compared to those of the non-renal scar group. There were no significant differences in age and sex between the two groups.
: The presence and grade of VUR, the duration of fever before treatment, prolonged fever over 5 days, ESR, and CRP were risk factors for renal scarring, irrespective of age and sex. Diagnosis and management of VUR, in children with UTI, is important to prevent renal scars.
Key Words: Unilateral vesicoureteral reflux , Renal scar , Urinary tract infection , 99mTc-DMSA renal scan

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