Renal parenchymal damage in male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection

S. Cascio, B. Chertin, E. Colhoun, Prem Puri, Antoine Khoury, Paddy Dewan, Craig A Peters

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Purpose: Vesicoureteral reflux during infancy is found mainly in males, and it is of high grade and often bilateral. The higher predominance of male infants is reported in series when the reflux is diagnosed prenatally and when it is detected after urinary tract infection. Renal parenchymal damage may already be present at birth before any episode of urinary tract infection or acquired after a febrile urinary tract infection. We evaluate the incidence of renal damage in a large series of male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection. Materials and Methods: We reviewed the medical and radiological records of 141 consecutive male infants 3 weeks to 1 year old (mean age 5.8 months) who were diagnosed with high grade (III to V) vesicoureteral reflux on voiding cystourethrography during 1984 to 2000 following hospitalization for the first febrile urinary tract infection. A total of 127 (90%) patients underwent 99technetium dimercapto-succinic acid scan to evaluate renal damage 3 to 6 months after the initial infection. Results: Vesicoureteral reflux was unilateral in 46 infants and bilateral in the remaining 95, comprising 236 ureters. Reflux was grade III in 79 ureters, IV in 114 and V in 43. Renal parenchymal damage was detected in 56 (44%) of the 127 infants on dimercapto-succinic acid scan, and was bilateral in 18 and unilateral in the 38, representing 74 renal refluxing units. Renal damage was mild (greater than 40% uptake) in 47 units, moderate (less than 40% and greater than 20% uptake) in 22 U and severe (less than 20% uptake) in 5 U. Conclusions: This study shows that nearly half of the male infants with high grade reflux who present with the first febrile urinary tract infection have renal parenchymal damage. This high incidence of renal damage may be explained by the coexistence of the 3 risk factors of gender, urinary tract infection and high grade vesicoureteral reflux.

Original languageEnglish (US)
Pages (from-to)1708-1710
Number of pages3
JournalJournal of Urology
Volume168
Issue number4 II
StatePublished - Oct 1 2002

Fingerprint

Vesico-Ureteral Reflux
Urinary Tract Infections
Kidney
Fever
Succinic Acid
Ureter
Incidence
Medical Records
Hospitalization
Parturition
Infection

Keywords

  • Infant, male
  • Kidney
  • Urinary tract infections
  • Vesico-ureteral reflux

ASJC Scopus subject areas

  • Urology

Cite this

Renal parenchymal damage in male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection. / Cascio, S.; Chertin, B.; Colhoun, E.; Puri, Prem; Khoury, Antoine; Dewan, Paddy; Peters, Craig A.

In: Journal of Urology, Vol. 168, No. 4 II, 01.10.2002, p. 1708-1710.

Research output: Contribution to journalArticle

Cascio, S, Chertin, B, Colhoun, E, Puri, P, Khoury, A, Dewan, P & Peters, CA 2002, 'Renal parenchymal damage in male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection', Journal of Urology, vol. 168, no. 4 II, pp. 1708-1710.
Cascio S, Chertin B, Colhoun E, Puri P, Khoury A, Dewan P et al. Renal parenchymal damage in male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection. Journal of Urology. 2002 Oct 1;168(4 II):1708-1710.
Cascio, S. ; Chertin, B. ; Colhoun, E. ; Puri, Prem ; Khoury, Antoine ; Dewan, Paddy ; Peters, Craig A. / Renal parenchymal damage in male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection. In: Journal of Urology. 2002 ; Vol. 168, No. 4 II. pp. 1708-1710.
@article{fed21545e26047e49074b8b4ed52fc21,
title = "Renal parenchymal damage in male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection",
abstract = "Purpose: Vesicoureteral reflux during infancy is found mainly in males, and it is of high grade and often bilateral. The higher predominance of male infants is reported in series when the reflux is diagnosed prenatally and when it is detected after urinary tract infection. Renal parenchymal damage may already be present at birth before any episode of urinary tract infection or acquired after a febrile urinary tract infection. We evaluate the incidence of renal damage in a large series of male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection. Materials and Methods: We reviewed the medical and radiological records of 141 consecutive male infants 3 weeks to 1 year old (mean age 5.8 months) who were diagnosed with high grade (III to V) vesicoureteral reflux on voiding cystourethrography during 1984 to 2000 following hospitalization for the first febrile urinary tract infection. A total of 127 (90{\%}) patients underwent 99technetium dimercapto-succinic acid scan to evaluate renal damage 3 to 6 months after the initial infection. Results: Vesicoureteral reflux was unilateral in 46 infants and bilateral in the remaining 95, comprising 236 ureters. Reflux was grade III in 79 ureters, IV in 114 and V in 43. Renal parenchymal damage was detected in 56 (44{\%}) of the 127 infants on dimercapto-succinic acid scan, and was bilateral in 18 and unilateral in the 38, representing 74 renal refluxing units. Renal damage was mild (greater than 40{\%} uptake) in 47 units, moderate (less than 40{\%} and greater than 20{\%} uptake) in 22 U and severe (less than 20{\%} uptake) in 5 U. Conclusions: This study shows that nearly half of the male infants with high grade reflux who present with the first febrile urinary tract infection have renal parenchymal damage. This high incidence of renal damage may be explained by the coexistence of the 3 risk factors of gender, urinary tract infection and high grade vesicoureteral reflux.",
keywords = "Infant, male, Kidney, Urinary tract infections, Vesico-ureteral reflux",
author = "S. Cascio and B. Chertin and E. Colhoun and Prem Puri and Antoine Khoury and Paddy Dewan and Peters, {Craig A}",
year = "2002",
month = "10",
day = "1",
language = "English (US)",
volume = "168",
pages = "1708--1710",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "4 II",

}

TY - JOUR

T1 - Renal parenchymal damage in male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection

AU - Cascio, S.

AU - Chertin, B.

AU - Colhoun, E.

AU - Puri, Prem

AU - Khoury, Antoine

AU - Dewan, Paddy

AU - Peters, Craig A

PY - 2002/10/1

Y1 - 2002/10/1

N2 - Purpose: Vesicoureteral reflux during infancy is found mainly in males, and it is of high grade and often bilateral. The higher predominance of male infants is reported in series when the reflux is diagnosed prenatally and when it is detected after urinary tract infection. Renal parenchymal damage may already be present at birth before any episode of urinary tract infection or acquired after a febrile urinary tract infection. We evaluate the incidence of renal damage in a large series of male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection. Materials and Methods: We reviewed the medical and radiological records of 141 consecutive male infants 3 weeks to 1 year old (mean age 5.8 months) who were diagnosed with high grade (III to V) vesicoureteral reflux on voiding cystourethrography during 1984 to 2000 following hospitalization for the first febrile urinary tract infection. A total of 127 (90%) patients underwent 99technetium dimercapto-succinic acid scan to evaluate renal damage 3 to 6 months after the initial infection. Results: Vesicoureteral reflux was unilateral in 46 infants and bilateral in the remaining 95, comprising 236 ureters. Reflux was grade III in 79 ureters, IV in 114 and V in 43. Renal parenchymal damage was detected in 56 (44%) of the 127 infants on dimercapto-succinic acid scan, and was bilateral in 18 and unilateral in the 38, representing 74 renal refluxing units. Renal damage was mild (greater than 40% uptake) in 47 units, moderate (less than 40% and greater than 20% uptake) in 22 U and severe (less than 20% uptake) in 5 U. Conclusions: This study shows that nearly half of the male infants with high grade reflux who present with the first febrile urinary tract infection have renal parenchymal damage. This high incidence of renal damage may be explained by the coexistence of the 3 risk factors of gender, urinary tract infection and high grade vesicoureteral reflux.

AB - Purpose: Vesicoureteral reflux during infancy is found mainly in males, and it is of high grade and often bilateral. The higher predominance of male infants is reported in series when the reflux is diagnosed prenatally and when it is detected after urinary tract infection. Renal parenchymal damage may already be present at birth before any episode of urinary tract infection or acquired after a febrile urinary tract infection. We evaluate the incidence of renal damage in a large series of male infants with high grade vesicoureteral reflux diagnosed after the first urinary tract infection. Materials and Methods: We reviewed the medical and radiological records of 141 consecutive male infants 3 weeks to 1 year old (mean age 5.8 months) who were diagnosed with high grade (III to V) vesicoureteral reflux on voiding cystourethrography during 1984 to 2000 following hospitalization for the first febrile urinary tract infection. A total of 127 (90%) patients underwent 99technetium dimercapto-succinic acid scan to evaluate renal damage 3 to 6 months after the initial infection. Results: Vesicoureteral reflux was unilateral in 46 infants and bilateral in the remaining 95, comprising 236 ureters. Reflux was grade III in 79 ureters, IV in 114 and V in 43. Renal parenchymal damage was detected in 56 (44%) of the 127 infants on dimercapto-succinic acid scan, and was bilateral in 18 and unilateral in the 38, representing 74 renal refluxing units. Renal damage was mild (greater than 40% uptake) in 47 units, moderate (less than 40% and greater than 20% uptake) in 22 U and severe (less than 20% uptake) in 5 U. Conclusions: This study shows that nearly half of the male infants with high grade reflux who present with the first febrile urinary tract infection have renal parenchymal damage. This high incidence of renal damage may be explained by the coexistence of the 3 risk factors of gender, urinary tract infection and high grade vesicoureteral reflux.

KW - Infant, male

KW - Kidney

KW - Urinary tract infections

KW - Vesico-ureteral reflux

UR - http://www.scopus.com/inward/record.url?scp=0036783986&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036783986&partnerID=8YFLogxK

M3 - Article

VL - 168

SP - 1708

EP - 1710

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 4 II

ER -