title: [Analysis of the prognosis and clinical factors in primary vesicoureteral reflux patients].
abstract: OBJECTIVE
  To analyze the relationship between the prognosis and clinical factors of primary vesicoureteral reflux (VUR) patients under the condition of non-surgical treatment.
  
  
  METHODS
  The medical records of the patients who were diagnosed as VUR by micturating cystourethrography (MCU) from January 2000 to December 2009 in Children's Hospital of Fudan University underwent non-surgical treatment, and followed up for more than one year then had repeated MCU, were retrospectively reviewed.
  
  
  RESULTS
  A total of 73 children (30 boys, 43 girls) were included in this study. The percentage of mild reflux (grade I-II) was 19.2% (14/73), that of moderate reflux (grade III) was 53.4% (39/73), and that of severe reflux (grade IV-V) was 27.4% (20/73). Among 73 patients, 27 (37.0%) patients were found to have renal damage. The average interval of repeated MCU was (1.29 ± 0.40) years (1 - 2 years). After follow-up, it was found that the reflux grade was relieved in 41 (56.2%) patients, of whom 27 (37.0%) patients achieved complete resolution, 32 (43.8%) patients did not have remission in reflux grade, of whom 13 (17.8%) patients had worsened reflux grade. Logistic regression analysis showed that VUR patients with renal damage at initial diagnosis was an important clinical factor to affect reflux remission (P = 0.000), complete resolving (P = 0.008) and result in worsening (P = 0.002).
  
  
  CONCLUSIONS
  A certain proportion of primary VUR patients could get reflux grade self-resolution, it was also quite common in severe VUR patients. VUR patients with renal damage at initial diagnosis was an important clinical factor affecting the reflux grade prognosis. Mild and moderate VUR patients with renal damage were at risk of worsening. VUR patients with high reflux grade had normal renal status could still get remission or even disappearance of VUR. But severe VUR patients with renal damage were still recommended to receive surgical therapy.
authors.affiliation: Department of Nephrology and Rheumatology, Children's Hospital of Fudan University, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Xu
authors.forename: Hong
authors.initials: H
authors.lastname: Xu
authors.forename: Li-jun
authors.initials: LJ
authors.lastname: Zhou
authors.forename: Qian
authors.initials: Q
authors.lastname: Shen
authors.forename: Li
authors.initials: L
authors.lastname: Sun
authors.forename: Yun-li
authors.initials: YL
authors.lastname: Bi
authors.forename: Xiang
authors.initials: X
authors.lastname: Wang
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix; D005260:Female; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000188:drug therapy / Q000473:pathology*
chemical_list: D000900:Anti-Bacterial Agents