title: Vesicoureteral reflux after kidney transplantation in children.
abstract: 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.
authors.affiliation: Département de Pédiatrie, hôpital Edouard Herriot, Lyon, France.
authors.forename: B
authors.initials: B
authors.lastname: Ranchin
authors.forename: F
authors.initials: F
authors.lastname: Chapuis
authors.forename: M
authors.initials: M
authors.lastname: Dawhara
authors.forename: I
authors.initials: I
authors.lastname: Canterino
authors.forename: A
authors.initials: A
authors.lastname: Hadj-Aïssa
authors.forename: M H
authors.initials: MH
authors.lastname: Saïd
authors.forename: B
authors.initials: B
authors.lastname: Parchoux
authors.forename: L
authors.initials: L
authors.lastname: Dubourg
authors.forename: J M
authors.initials: JM
authors.lastname: Pouillaude
authors.forename: D
authors.initials: D
authors.lastname: Floret
authors.forename: X
authors.initials: X
authors.lastname: Martin
authors.forename: P
authors.initials: P
authors.lastname: Cochat
mesh_terms: 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*