Long-term outcome of vesicoureteral reflux associated chronic renal failure in children. Data from the ItalKid Project
- PMID: 15201801
- DOI: 10.1097/01.ju.0000129067.30725.16
Long-term outcome of vesicoureteral reflux associated chronic renal failure in children. Data from the ItalKid Project
Abstract
Purpose: The nephropathy associated with vesicoureteral reflux (VUR) is one of the leading causes of chronic renal failure (CRF) in children. We describe the clinical course of the disease based on information available in the ItalKid Project database, and analyze the predictive value of baseline renal function, age at VUR diagnosis and urinary protein excretion in relation to the risk of progressive renal failure.
Materials and methods: As of December 31, 2001 the registry included a total of 343 patients (261 males) with a diagnosis of primary VUR, which was the leading single cause of CRF, accounting for 25.4% of all patients with CRF.
Results: The estimated risk of end stage renal disease (ESRD) by age 20 years was 56%. The patients with a creatinine clearance (Ccr) of less than 40 ml per minute at baseline had an estimated 4-fold greater risk of ESRD developing in comparison with those whose Ccr was 40 to 75 ml per minute. No significant difference in probability of disease progression to ESRD was found between subjects diagnosed with VUR at age 6 months or less and those diagnosed later (older than 6 months). Furthermore, children with normal urinary protein excretion (a urinary protein [uPr]/urinary creatinine [uCr] ratio of less than 0.2 in 36 patients) and low grade proteinuria (uPr/uCr 0.2 to 0.8 in 34 patients) at baseline showed a significantly slower decrease in mean Ccr than those with moderate proteinuria (uPr/uCr greater than 0.8 in 34 patients). Hypertension and/or antihypertensive treatment (including antiprogressive drugs) were reported in 29.1% of patients.
Conclusions: The results of the present study define the long-term risk of ESRD in a large population of children with CRF and VUR, and provide some critical information for identifying the prognosis.
Similar articles
-
Epidemiology of chronic renal failure in children: data from the ItalKid project.Pediatrics. 2003 Apr;111(4 Pt 1):e382-7. doi: 10.1542/peds.111.4.e382. Pediatrics. 2003. PMID: 12671156
-
Predictive risk factors for chronic renal failure in primary high-grade vesico-ureteric reflux.BJU Int. 2004 Jun;93(9):1309-12. doi: 10.1111/j.1464-410X.04866.x. BJU Int. 2004. PMID: 15180629
-
Severe vesicoureteral reflux and chronic renal failure: a condition peculiar to male gender? Data from the ItalKid Project.J Pediatr. 2004 May;144(5):677-81. doi: 10.1016/j.jpeds.2004.01.043. J Pediatr. 2004. PMID: 15127014
-
Vesicoureteral reflux and reflux nephropathy.Am J Nephrol. 1982;2(5):245-50. doi: 10.1159/000166654. Am J Nephrol. 1982. PMID: 6764861 Review.
-
Vesicoureteral reflux and reflux nephropathy.Adv Chronic Kidney Dis. 2011 Sep;18(5):348-54. doi: 10.1053/j.ackd.2011.07.006. Adv Chronic Kidney Dis. 2011. PMID: 21896376 Free PMC article. Review.
Cited by 17 articles
-
Primary Vesicoureteral reflux and chronic kidney disease in pediatric population. What we have learnt?Int Braz J Urol. 2020 Mar-Apr;46(2):262-268. doi: 10.1590/S1677-5538.IBJU.2020.02.02. Int Braz J Urol. 2020. PMID: 32022517 Free PMC article. No abstract available.
-
Estimation of the relationship between the polymorphisms of selected genes: ACE, AGTR1, TGFβ1 and GNB3 with the occurrence of primary vesicoureteral reflux.Int Urol Nephrol. 2017 Mar;49(3):387-397. doi: 10.1007/s11255-016-1483-9. Epub 2016 Dec 17. Int Urol Nephrol. 2017. PMID: 27988909 Free PMC article.
-
Increasing the Reliability of the Grading System for Voiding Cystourethrograms Using Ultrasonography: An Inter-Rater Comparison.Nephrourol Mon. 2016 Jul 31;8(5):e38685. doi: 10.5812/numonthly.38685. eCollection 2016 Sep. Nephrourol Mon. 2016. PMID: 27878111 Free PMC article.
-
Reliability of grading of vesicoureteral reflux and other findings on voiding cystourethrography.J Pediatr Urol. 2017 Apr;13(2):192-198. doi: 10.1016/j.jpurol.2016.06.020. Epub 2016 Sep 6. J Pediatr Urol. 2017. PMID: 27666144 Free PMC article. Clinical Trial.
-
Reliability of the Grading System for Voiding Cystourethrograms in the Management of Vesicoureteral Reflux: An Interrater Comparison.Adv Urol. 2016;2016:1684190. doi: 10.1155/2016/1684190. Epub 2016 Mar 16. Adv Urol. 2016. PMID: 27069475 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical
Research Materials