[Voiding dysfunction in children with vesicoureteral reflux].
The aim of the study was to assess the rate of development of voiding dysfunction (VD) in patients with reflux nephropathy. We investigated 150 pts with vesicoureteral reflux (VUR): 33 boys and 117 girls in mean age 9 +/- 3.3 years with normal renal function. In all pts we performed renal scintigraphy (DMSA) and ABPM. Renal scarring by DMSA scan was categorized into grades 1-4. In all pts we assessed high and laterality of VUR, renal function (clearance creatinine--Ccr) and occurency of hypertension (HT).


RESULTS
Of 150 pts, 80 (53.3%) developed VD (54.5% boys and 52% girls). DMSA grade: 1--27 pts, 2--85 pts; 3--31 pts; 4--7 pts. No statistically significant difference was found depends of: sex, age, laterality of renal damage in DMSA, unilateral and bilateral reflux for the development of VD. The incidence 3-4 grade in DMSA scan was significantly higher in pts with IV-V grade of VUR in comparison to pts with lower grade of VUR in group with and without voiding dysfunction. IV-V grades of VUR were observed more frequently in pts with bladder/sphincter dysfunction. The occurency of HT in group with VD and without VD was 12 pts (15%) and 8 (11.4%) respectively (ns). Pts with VD have lower Ccr in comparison with pts without VD (129.1 vs 136.3 ml/min/1.73 m2; p<0.05).


CONCLUSIONS
Approximately 50% of patients with VUR demonstrated VD. VD occurred independent of age. IV-V degrees VUR and more severe changes in DMSA scan were seen in pts with bladder/sphincter dysfunction.
Szymanik-Grzelak
Hanna
H
Katedra i Klinika Pediatrii i Nefrologii, Akademii Medycznej w Warszawie. nefrologia@litewska.edu.pl
Sladowska
Joanna
J
Pańczyk-Tomaszewska
Małgorzata
M
Sekowska
Renata
R
Roszkowska-Blaim
Maria
M
D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000503:physiopathology; D008297:Male; D012074:Remission Induction; D012189:Retrospective Studies; D018666:Ureteroscopy / Q000379:methods; D014549:Urinary Incontinence / Q000209:etiology* / Q000503:physiopathology*; D014718:Vesico-Ureteral Reflux / Q000145:classification / Q000150:complications* / Q000503:physiopathology*