All issues > Volume 45(12); 2002

Original Article

J Korean Pediatr Soc. 2002;45(12):1540-1545. Published online December 15, 2002.

Incidence of Vesicoureteral Reflux in Asymptomatic Siblings of Patients with Reflux

Jong Shik JS Kim¹, Ja Wook JW Koo¹

¹Department of Pediatrics, Inje University College of Medicine, Seoul, Korea

Correspondence Ja Wook JW Koo ,Email: iris0422@unitel.co.kr

Abstract

Purpose
: Vesicoureteral reflux(VUR) is defined as a retrograde flow of urine from the bladder into the upper urinary tract. It has been shown to predispose patients to hypertension, renal scarring, and end-stage renal failure if not recognized and treated. The observation that VUR occurs in siblings of children with reflux at a significantly higher rate than the general pediatric population has been recognized for many years and VUR was detected in 26% to 51% of siblings of patients with VUR. The purpose of this study is to determine the incidence of VUR in asymptomatic siblings of children with VUR and to see if this form of screening would be practical.
Methods
: We retrospectively reviewed the records of 28 patients with VUR and their siblings. The total number of asymptomatic siblings investigating VUR were 28 persons. All patients and siblings were evaluated for VUR by a voiding cystourethrography and all patients and siblings with VUR were performed 99mTc 2,3-dimercaptosuccinic acid renal scan.
Results
: A total of 28 patients(14 boys, 14 girls) with VUR were studied; the mean patient age was 2.7 years(range 1 month to 8.4 years). The total number of asymptomatic siblings investigating VUR were 28 persons(17 boys, 11 girls) and the mean age was 3.3 years(range 2 months to 7.4 years). Renal scar was detected in 20 of 28(71.4%) patients with VUR. VUR was noted in three of 28(10.7%) siblings and renal scar was detected in one of three siblings with VUR.
Conclusion
: In this study, the predictive value of a positive family history alone in identifying VUR was 10.7%. This incidence suggests more investigation of asymptomatic siblings and continued study of this group of patients at risk is needed for clarifying the family screening of patients with VUR.

Keywords :Vesicoureteral reflux, Reflux nephropathy, Urinary tract infection