title: Renal scarring is associated with nonsecretion of blood type antigen in children with primary vesicoureteral reflux.
abstract: OBJECTIVE
  Nonsecretor status of blood type antigen has been associated with higher risk of urinary tract infection (UTI) in women. However its implication in the modern management for pediatric UTI remains unclear. We evaluate the impact of secretor status on clinical course in children with primary vesicoureteral reflux (VUR).
  
  
  METHODS
  From 1998 to 2002, 382 cases of primary VUR presented to our institute and were treated either surgically or nonoperatively in accordance with the American Urological Association guideline. Of these potential candidates 128 patients and their guardians volunteered to be entered into the study. Antiseptic swabs to collect saliva were sent to them. The secretor status was determined using the hemagglutination inhibition assay from the eluted saliva on the swabs and medical records of responders were evaluated retrospectively.
  
  
  RESULTS
  Secretor status was not associated with gender, VUR grade, presentation, history of breakthrough UTI, laterality of VUR and conservative vs surgical treatment. However, nonsecretor status weakly correlated with decreased split renal function and significantly correlated with the presence of focal renal scarring (40.9% vs 21.7% for children with and without scarring, respectively) as determined by technetium dimercapto-succinic acid renal scan.
  
  
  CONCLUSIONS
  These results demonstrate that secretor status represents unrecognized host disposition that affects the clinical course of primary VUR. Further study is needed to determine the significance of secretor status for clinical management and pathophysiology of VUR.
authors.affiliation: Department of Urology, Kyoto University, Kyoto, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kanematsu
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Kaoru
authors.initials: K
authors.lastname: Yoshino
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishitoya
authors.forename: Akito
authors.initials: A
authors.lastname: Terai
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Sugita
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
authors.forename: Saburo
authors.initials: S
authors.lastname: Tanikaze
mesh_terms: D001789:Blood Group Antigens / Q000276:immunology*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000150:complications* / Q000000981:diagnostic imaging; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D010641:Phenotype; D011866:Radioisotope Renography; D012189:Retrospective Studies; D012463:Saliva / Q000737:chemistry; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014552:Urinary Tract Infections / Q000097:blood* / Q000209:etiology; D014718:Vesico-Ureteral Reflux / Q000097:blood* / Q000150:complications / Q000628:therapy
chemical_list: D001789:Blood Group Antigens; D019783:Technetium Tc 99m Dimercaptosuccinic Acid