The prognostic impact of an abnormal initial renal ultrasound on early reflux resolution.
OBJECTIVE
In a group of children diagnosed with vesicoureteral reflux (VUR) we evaluated renal ultrasound findings, associated findings on renal scan, and prognostic impact on VUR resolution.


METHODS
Medical records were reviewed for children with primary reflux and no history of antenatal hydronephrosis who underwent an initial renal ultrasound. Abnormal renal ultrasound was defined as hydronephrosis or relative difference in renal size ≥1 cm. Reflux resolution was evaluated at 2 years post diagnosis.


RESULTS
In 129 children with VUR (111 girls, 18 boys), 39 (30%) had an abnormal renal ultrasound. Two-year VUR resolution in the abnormal renal ultrasound group was 21% versus 46% in the group with normal renal ultrasound (P = 0.01). Combining grade II and III reflux, an abnormal ultrasound was associated with a statistically significantly lower resolution rate (grade II-III 23% vs 47%, P = 0.049). For children with moderate hydronephrosis, 8/9 (89%) had abnormal initial renal scans and all failed to achieve resolution of reflux at 2 years.


CONCLUSIONS
In this cohort of children with VUR, 30% had abnormalities on renal ultrasound. The presence of moderate hydronephrosis on ultrasound may indicate a high likelihood of abnormality on renal scan and failure to achieve early resolution of VUR.
Nepple
Kenneth G
KG
University of Iowa, Division of Pediatric Urology, Iowa City, IA, USA.
Arlen
Angela M
AM
Austin
J Christopher
JC
Cooper
Christopher S
CS
D002675:Child, Preschool; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014463:Ultrasonography / Q000706:statistics & numerical data*; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging* / Q000453:epidemiology*