Sun, 09/12/2010 - 05:46 | by admin
Relevance of VUR in children prone to UTI
Vesicoureteral reflux (VUR) increases the potential for a UTI to spread towards the kidneys. Evidence suggests that the presence of VUR alone is unlikely to lead to permanent renal damage. However, the condition increases the risk of secondary consequences associated with upper UTI.
In one study, significantly more children with VUR were found to have permanent renal damage compared with those without VUR (72% vs. 52%, respectively; p<0.0001).1 As children grow and their urinary tract matures, VUR often resolves without intervention. As a result, the condition is more prevalent in younger children and infants under two years of age. Importantly, this age group is also most susceptible to renal damage as a result of recurrent UTIs.
Despite the tendency for spontaneous resolution, more severe cases of VUR can persist for many years. For example, in a study of children with VUR grade III or IV, nearly half of the patients still had VUR after ten years.2 This emphasizes the need to diagnose and treat VUR during the early stages, to protect children from potential renal damage in the future.
- Orellana P, Baquedano P, Rangarajan V, et al. Relationship between acute pyelonephritis, renal scarring, and vesicoureteral reflux. Results of a coordinated research project. Pediatr Nephrol 2004; 19: 1122–1126.
- Smellie JM, Jodal U, Lax H, et al. Outcome at 10 years of severe vesicoureteric reflux managed medically: Report of the International Reflux Study in Children. J Pediatr 2001; 139: 656–663.