Spontaneous resolution of vesicoureteral reflux (VUR) in Iranian children: A single center experience in 533 cases

authors:

avatar Mostafa Sharifian 1 , * , avatar Hamed Zinsaz Boroujerdi 2 , avatar Reza Dalirani 2 , avatar Saeed Maham 2 , avatar Mohsen Akhavan Sepahi 3 , avatar Abdollah Karimi 4 , avatar Maryam Ghaffari Shad 4 , avatar Masoud Dadkhah Chymeh 4 , avatar Maryam Sharifian 5

Pediatric Infections Research Center (PIRC), Shahid Beheshti University of Medical Sciences, sharifian.dorche@gmail.com, IR Iran
Pediatric Infections Research Center (PIRC), Shahid Beheshti University of Medical Sciences, IR.Iran
Department of Pediatrics, Qom University of Medical Sciences and Health Services, IR.Iran
Pediatric Infections Research Center (PIRC), Shahid Beheshti University of Medical Sciences, IR Iran
Department of Neurology, University of Medical Sciences, Shiraz, IR Iran
Nephro-Urology Monthly: Vol.3, issue 3; 191-195
article type: Research Article
received: October 30, 2010
accepted: January 2, 2011

how to cite: Sharifian M, Boroujerdi H, Dalirani R, Maham S, Sepahi M, et al. Spontaneous resolution of vesicoureteral reflux (VUR) in Iranian children: A single center experience in 533 cases. Nephro-Urol Mon. 2011;3(3): 191-195. 

Abstract

Background: Experience with vesicoureteral reflux (VUR) resolution differs in different centers.
Objective: The aim of this study was to evaluate the epidemiologic characteristics and outcome of VUR among Iranian children.
Patients and Methods: In this cohort study, 1278 children with urinary tract infection (UTI) who were visited at the pediatric nephrology clinic; Tehran, IR Iran during 1999 to 2007 were studied. Following the diagnosis, patients received prophylactic low-dose oral antibiotic and one to two yearly follow-ups with Radionuclide Cystography (RNC). Patients underwent surgery in case of breakthrough infection or new renal scar formation.
Results: Vesicoureteral reflux was found in 533 patients (42%) with a mean age of 6.3± 3.6 years (Range 2 days to 18 years), out of which 436 (82%) were females. During 3.3 ± 2.2 years follow-up, spontaneous resolution was observed in 109 (39%) of 279 patients with follow-up RNCs. Mean time to spontaneous resolution was 1.5 ± 1 years. Frequencies of VUR grades at initial investigation were 18%, 37%, 26%, 11% and 8% for grades I to V respectively, and 46% had bilateral VUR. Grades I to V resolved in 63%, 57%, 27%, 22% and 10%, respectively. Anti reflux surgery was performed in 27(10%) of patients. Two handred fourty nine patients proceeded to follow-up with Dimercaptosuccinic acid (DMSA) scan. There were 4 (4%) renal scars in patients with spontaneous resolution and 8 (5%) renal scars in patients without spontaneous resolution of VUR (P > 0.05).
Conclusions: According to the excellent results with medical therapy, it is recommended that VUR grades 1 to 4 be managed medically with low-dose antibiotic prophylaxis and close follow-ups. 

 

 

Implication for health policy/practice/research/medical education:
Due to importance of VUR in children that it can be progressed to CKD, this article will focus on the benefit of medical treatment and close follow-up of these patients.
Please cite this paper as:
Sharifian M, Boroujerdi HZ, Dalirani R, Maham S, Sepahi MA, Jahromy MH, et al. Spontaneous resolution of vesicoureteral reflux (VUR) in Iranian children: A single center experience in 533 cases. Nephro-Urol Mon. 2011;3(3):191-195.
Article history:
Received: 30 Oct 2010
Revised: 18 Dec 2010
Accepted: 2 Jan 2011

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