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Factors Associated with Renal Failure in Children with Primary Vesicoureteral Reflux

Journal of the Korean Pediatric Society 1999;42(7):959-965.
Published online July 15, 1999.
Factors Associated with Renal Failure in Children with Primary Vesicoureteral Reflux
Kyung Mi Park1, Kyung Hoon Paek1, Jae Hong Min1, Jung Su Kim1, Il Soo Ha1, Kwang Myung Kim2, Hae Il Cheong1, Hwang Choi2, Yong Choi1
1Department of Pediatrics, Seoul National University, College of Medicine, Seoul, Korea
2Department of Pediatric Urology, Seoul National University, College of Medicine, Seoul, Korea
원발성 방광요관역류에서 신부전 발생과 관련된 인자들
박경미1, 백경훈1, 민재홍1, 김정수1, 하일수1, 김광명2, 정해일1, 최황2, 최용1
1서울대학교 의과대학 소아과학교실
2서울대학교 의과대학 비뇨기과학교실
: The pathophysiologic mechanisms and risk factors of renal functional deterioration are still controversial. We analyzed the factors associated with renal failure in children with primary vesicoureteral reflux.
: The medical records of 166 children who were diagnosed with primary vesicoureteral reflux from Jan. 1985 to Dec. 1996 in the Department of Pediatrics, Seoul National University Children's Hospital were reviewed retrospectively. The patients were divided into two groups according to renal function: patients with renal failure(RF group) and patients with normal renal function(NRF group).
: Eighteen(11%) were classified as RF group, and 16(89%) of them were male. Sixteen (89%) of RF group revealed decreased renal function at the time of diagnosis. There was no past history of documented urinary tract infection in 16(89%) of RF group. Patients of RF group had a higher grade of reflux as compared with those of NRF group. Proteinuria and hypertension were found in 16(89%) and 6(33%) of RF group, respectively, while no NRF patients had proteinuria or hypertension. Renal functional deterioration had progressed to end-stage renal disease in 6(33%) of RF group during a mean follow-up of 4.4¡¾2.7(range 0.5-12) years.
: Reflux nephropathy and renal scar in children can be prevented, in some cases, by early diagnosis of vesicoureteral reflux and prophylaxis of urinary tract infection. Regular check up for proteinuria and hypertension is essential for early detection of renal dysfunction. However, in other patients, especially in male, renal dysfunction can develop independently on urinary tract infection.
Key Words: Vesicoureteral reflux, Reflux nephropathy, Renal failure

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