Abnormal renal scans and decreased early resolution of low grade vesicoureteral reflux.
OBJECTIVE
Limited studies suggest a relationship between scarring on renal scan and failure to resolve vesicoureteral reflux. We evaluated the impact of abnormal renal scans on early vesicoureteral reflux resolution.


METHODS
The medical records and renal scans were reviewed of children diagnosed with primary reflux between 1988 and 2004. We defined an abnormal renal scan as renal scarring or relative renal function 40% or less. Reflux resolution was noted 1 and 2 years after diagnosis.


RESULTS
Renal scan data were available on 161 children with vesicoureteral reflux, including 127 girls and 34 boys. Relative renal function was 15% or less in 7 children, 16% to 35% in 14, 36% to 40% in 18 and greater than 40% in 122. Of the 161 patients 79 (43%) had an abnormal renal scan, including 37% with grades 1 to 3 reflux. The rate of 2-year reflux resolution in the abnormal and normal renal scan groups was 13% vs 53%. Of children with grades II and III reflux those with an abnormal renal scan were less likely to have reflux resolution compared to those with normal renal scans (23% vs 55% and 4% vs 41, respectively, p <0.05). The same relationship was present at 1 year for grades 2 and 3 (18% vs 49% and 4% vs 30, respectively, p <0.05).


CONCLUSIONS
Abnormal renal scans are an important independent predictor of early failure to resolve vesicoureteral reflux. An abnormal renal scan should be considered when counseling families about the likelihood of early reflux resolution. Performing a renal scan may be indicated in select patients.
Nepple
Kenneth G
KG
Division of Pediatric Urology, University of Iowa, Iowa City, Iowa 52242-1089, USA.
Knudson
Matthew J
MJ
Austin
J Christopher
JC
Cooper
Christopher S
CS
D000328:Adult; D002675:Child, Preschool; D002921:Cicatrix / Q000000981:diagnostic imaging; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging*; D007674:Kidney Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000473:pathology; D008297:Male; D011247:Pregnancy; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D014552:Urinary Tract Infections / Q000209:etiology; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000000981:diagnostic imaging*