[Chronic renal failure secondary to vesicoureteral reflux: is the prevention possible?].
Vesicoureteral reflux (VUR) is the commonest cause of end-stage renal failure reported by the ITALKID (Italian Register of Chronic Renal Failure) (CRF) in children (0-15 years). Herein we report 131 children (53 M and 78 F) with a diagnosis of VUR made in our Centre between 1987 and 1994. Diagnosis was made in 69% of cases (85/131) during the 1st year of life and in 31% of cases (47/131) afterwards. VUR was demonstrated following a prenatal ultrasonography suspicion in 24/131 and after symptoms such as urinary tract infection (94/131) and poor growth (6/131). 75/131 of patients were treated conservatively (continuous chemoprophylaxis) while 56/131 underwent an antireflux surgery. CRF was found in 14% (19/131) of cases even though the diagnosis of VUR was performed in most of the cases (79%) during the 1st year of life. In conclusion prenatal ultrasonography has a low sensibility in the diagnosis of VUR. In addition, an early diagnosis made during the 1st year of life do not prevent CRF. The study was carried out in a Centre where patients with urological problems are referred from a large part of Northern East of Italy and this may explain the high prevalence of CRF and of children receiving a surgical treatment.
Zamorani
E
E
Dipartimento di Pediatria, Università degli Studi di Padova, Italia.
Andreetta
B
B
Dall'Amico
R
R
Montini
G
G
Passerini Glazel
G
G
Zacchello
G
G
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D019072:Antibiotic Prophylaxis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D011247:Pregnancy; D016216:Ultrasonography, Prenatal; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000175:diagnosis / Q000601:surgery