Followup study of renal function in children with reflux nephropathy after resolution of vesicoureteral reflux.
OBJECTIVE
We evaluated data collected for 10 years on children with reflux nephropathy to identify a means of predicting the prognosis.


METHODS
A total of 15 boys and 13 girls were enrolled in this study at least 2 years after surgical and spontaneous resolution of vesicoureteral reflux in 25 and 3 patients, respectively. They were followed for more than 10 years and renal function was periodically evaluated. Urinary beta 2-microglobulin, alpha 1-microglobulin, N-acetyl-beta-D-glucosaminidase, microalbumin and 99mtechnetium dimercapto-succinic acid uptake were measured.


RESULTS
Of the 28 patients 12 had high levels of urinary alpha 1-microglobulin during followup, including all 7 in whom renal function deteriorated. In 3 children with elevated alpha 1-microglobulin urinary microalbumin gradually increased after puberty. Although elevated levels of urinary beta 2-microglobulin, N-acetyl-beta-D-glucosaminidase and microalbumin were also observed, they were less predictive of renal function than alpha 1-microglobulin.


CONCLUSIONS
These results suggest that elevated urinary levels of alpha 1-microglobulin may predict the risk of abnormal renal function in children with reflux nephropathy even before the appearance of significant proteinuria.
Konda
R
R
Department of Urology, Tohoku University School of Medicine, Sendai, Japan.
Sakai
K
K
Ota
S
S
Takeda
A
A
Orikasa
S
S
D000118:Acetylglucosaminidase / Q000652:urine; D000293:Adolescent; D000419:Albuminuria; D000510:Alpha-Globulins / Q000652:urine; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007674:Kidney Diseases / Q000209:etiology / Q000503:physiopathology; D007677:Kidney Function Tests; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D012680:Sensitivity and Specificity; D004113:Succimer / Q000378:metabolism; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000628:therapy; D001613:beta 2-Microglobulin / Q000652:urine
D000510:Alpha-Globulins; C016001:alpha-1-microglobulin; D001613:beta 2-Microglobulin; D004113:Succimer; D000118:Acetylglucosaminidase