title: Renal scarring and vesicoureteral reflux in children with myelodysplasia.
abstract: The records of 180 myelodysplasia patients followed from 3 to 18 years were reviewed. Studies included cystography to evaluate vesicoureteral reflux and dimercapto-succinic acid renal scintigraphy to identify acute inflammation and renal scarring. Scarring was noted in 28 of 180 patients (15.5%), of whom 68% were girls. Of the patients with renal scarring 75% had associated reflux and 40% over-all were identified as having reflux. Management of patients with vesicoureteral reflux included clean intermittent catheterization, antibiotic prophylaxis and anticholinergics when indicated. Only 17 of 72 patients (24%) had ureteral reimplantation. Surgical indications included persistent high grade reflux and/or progressive upper tract damage. Reflux resolved in 62% of those on medical management. Resolution was not dependent on grade of reflux (as compared to primary reflux). Twenty-one patients are stable and being followed with persistent reflux. In 7 patients new renal scars developed during aggressive medical management, 5 of whom underwent subsequent surgical correction.
authors.affiliation: Department of Urology, Children's Hospital, Washington, D.C. 20010.
authors.forename: R A
authors.initials: RA
authors.lastname: Cohen
authors.forename: H G
authors.initials: HG
authors.lastname: Rushton
authors.forename: A B
authors.initials: AB
authors.lastname: Belman
authors.forename: E J
authors.initials: EJ
authors.lastname: Kass
authors.forename: M
authors.initials: M
authors.lastname: Majd
authors.forename: C
authors.initials: C
authors.lastname: Shaer
mesh_terms: D002648:Child; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D009436:Neural Tube Defects / Q000150:complications*; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D004113:Succimer; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology* / Q000628:therapy
chemical_list: D015609:Organotechnetium Compounds; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D004113:Succimer