Vesicoureteral reflux after kidney transplantation in children.
BACKGROUND
The prevalence and significance of vesicoureteral reflux (VUR) after kidney transplantation in adults varies between authors and there have been few reports in children.


METHODS
We conducted a retrospective study in a single-centre paediatric cohort. Fifty-five of the 84 children who underwent kidney transplantation over a 5-year period were checked with routine cystography after a median of 8 months post-transplantation. Graft function and urinary-tract infections were assessed during the first 6 years after transplantation.


RESULTS
VUR into the graft was present in 58% of the patients. Graft function and incidence of urinary-tract infections were similar in the two groups, independent of VUR. After having excluded infections attributed to the presence of a catheter, actuarial survival rates without pyelonephritis and without pyelonephritis following a first lower urinary-tract infection were worse in patients with VUR (P:=0.017 and P:=0.0039 respectively). None of the eight patients with VUR treated with antibiotic prophylaxis after a first acute pyelonephritis (APN) episode presented subsequent APN after 4.4+/-3.3 years on therapy.


CONCLUSIONS
VUR to the graft occurred in more than half paediatric renal transplant recipients. This condition was associated with an increased risk of APN. Long-term antibiotic prophylaxis seems to be able to prevent APN in transplanted children with VUR.
Ranchin
B
B
Département de Pédiatrie, hôpital Edouard Herriot, Lyon, France.
Chapuis
F
F
Dawhara
M
M
Canterino
I
I
Hadj-Aïssa
A
A
Saïd
M H
MH
Parchoux
B
B
Dubourg
L
L
Pouillaude
J M
JM
Floret
D
D
Martin
X
X
Cochat
P
P
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007223:Infant; D016030:Kidney Transplantation / Q000401:mortality / Q000502:physiology; D008297:Male; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D014552:Urinary Tract Infections / Q000453:epidemiology; D014718:Vesico-Ureteral Reflux / Q000453:epidemiology*