Contralateral vesicoureteral reflux in children with a multicystic kidney.
Multicystic kidneys are commonly diagnosed today due to the widespread use of prenatal ultrasound. Children with a multicystic kidney are at increased risk of contralateral renal abnormalities. We performed a voiding cystourethrogram on 65 children with a newly diagnosed multicystic kidney to determine the incidence of contralateral vesicoureteral reflux. Ten children (15%) with a multicystic kidney had contralateral vesicoureteral reflux, including 8 of 37 boys (22%) and 2 of 28 girls (7%). Contralateral reflux occurred in significantly more white (22%) than nonwhite (4%) patients (p < 0.001). Reflux was grade I in 2 children, II in 2, III in 2, IV in 1 and V in 3. All children were placed on antimicrobial prophylaxis. During a mean followup of 3.1 years grades I and II reflux resolved. Grade III reflux resolved in 1 child and remained stable in 1. Grade IV reflux was downgraded to III in 1 child on prophylaxis. One child with grade V reflux was stable on prophylaxis while the remaining 2 patients underwent ureteroneocystostomy. No child had a urinary tract infection. A significant proportion of white children with a multicystic kidney have contralateral vesicoureteral reflux and initial imaging should include a voiding cystourethrogram.
Selzman
A A
AA
Department of Urology, Rainbow Babies and Children's Hospital, Case Western Reserve University, School of Medicine, Cleveland, Ohio.
Elder
J S
JS
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D007690:Polycystic Kidney Diseases / Q000150:complications* / Q000151:congenital / Q000175:diagnosis; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000209:etiology*