Primary vesicoureteral reflux in children in southern Iran

ABSTRACT

Experience with vesicoureteral reflux [VUR] differs in different centers and there is plenty of controversies. To evaluate the outcome of primary VUR complications and the rate of recurrence of UTI. In a retrospective study, the medical charts of all infants and children with primary VUR who were followed up by one nephrologist were reviewed. During 16 years, 271 patients [226 females, 45 males] with 401 refluxing ureters were followed up as primary VUR. The patients' age at diagnosis was 4 days to 16 years [Mean 4.4 years] and the mean duration of follow-up was 4.2 years. Urinary tract infection [UTI] was the presenting symptom in 97% and fever was recorded in 30% of cases. Frequencies of different grades of VUR at initial investigation were 6.5%, 52%, 23.4% and 18.1% for grades I to IV, respectively. The responsible microorganism in 90% of the first episodes of UTI was E. coli. Scarring or small size kidney was present in 63 patients. Recurrence of UTI in VUR of grades I to IV, were 68.7%, 51%, 60.1% and 46.8%, respectively. Follow-up voiding cystourethrogram revealed resolution of VUR in 52%, improvement in 31%, no change in 11%, and deterioration in 6%. Complications such as chronic renal failure, hypertension and renal tubular acidosis were observed in 11, 10 and 9 patients, respectively. Symptomatic primary VUR is more common and has better prognosis in girls. Recurrence of UTI is not related to the grade of VUR