[Renal damage in vesicoureteral reflux associated to duplex pyeloureteral system].
Duplex pyeloureteral system (DPS) is common and it can be associated to others anomalies, as vesicoureteral reflux (VUR) in the lower moiety and ureterocele in the upper moiety. The VUR in a DPS can be primary or secondary. Assessment of parenchymal uptake is important.


OBJECTIVE
To determine the presence of renal damage (RD) in children with a complete refluxing DS in relationship with clinical presentation and type of VUR.


METHODS
Retrospectively we evaluated 56 children; 39 girls and 17 boys with an average age of 3.58 years old, with VUR into complete DPS (61 renal units [RU] with DS, 45 of them with primary VUR). Forty-four out of 56 children were evaluated due to urinary tract infection.


RESULTS
Twenty-eight out of 61 RU (46 %) had RD. Twenty-one out of 45 RU with primary VUR (46.7 %) had RD and 7 out of 16 RU with secondary VUR had RD (ns). 72.7 % of children with antenatal diagnosis had RD versus 40.8 % of those studied after urinary tract infection (p = 0.04).


CONCLUSIONS
RD is frequent in VUR into complete DPS; 46 % in our experience. There is no significant difference between primary and secondary VUR. RD was more frequent in the group of children with antenatal diagnosis. Renal scintigraphy provides an accurate assessment of the functional renal parenchyma, supporting the therapeutical decision.
Orellana
P
P
Departamento de Radiología y Pediatría, Pontificia Universidad Católica de Chile, Santiago, Chile. pilar@med.puc.cl
Pizarro
M E
ME
García
F
F
Baquedano
P
P
D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000175:diagnosis / Q000196:embryology; D004198:Disease Susceptibility; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging* / Q000473:pathology; D007682:Kidney Pelvis / Q000002:abnormalities*; D008297:Male; D011296:Prenatal Diagnosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D012189:Retrospective Studies; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014513:Ureter / Q000002:abnormalities*; D014552:Urinary Tract Infections / Q000209:etiology; D014718:Vesico-Ureteral Reflux / Q000209:etiology*
D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid