title: Detecting reflux: does ureteric jet Doppler waveform have a role?
abstract: BACKGROUND
  Vesicoureteral reflux (VUR) has a prevalence of 30-40 % post-febrile urinary tract infection (UTI). If not detected early and treated, renal scarring, hypertension, and renal failure may occur. Micturating cystourethrography (MCU) is an invasive procedure associated with radiation exposure. Hence, this study aimed at evaluating the utility of ureteric jet Doppler waveform (UJDW) as a screening tool in detecting VUR, and at assessing the feasibility of performing it in children aged 2-4 years.
  
  
  METHODS
  Any child 2-18 years old who needed an MCU was included. Exclusion criteria were active UTI, indwelling catheter, and inability to drink the required amount of fluid. The UJDW was performed prior to the MCU.
  
  
  RESULTS
  One hundred eighty-two ureteric units were analyzed. Sensitivity and specificity of UJDW in detecting VUR was 80.3 and 87.9 %. Twenty-three children (45 ureteric units), aged 2-4 years were compared with 73 children (137 ureteric units), aged 5-18 years. Sensitivity and specificity of UJDW in detecting VUR in 2-4 years was 77.3 and 91.3 %, respectively; while in children ≥5 years, it was 81.8 and 87.1 %, respectively.
  
  
  CONCLUSIONS
  UJDW has a uniformly high specificity regardless of age or etiological groups, making it a good tool for follow-up. UJDW is a feasible technique, even in children aged 2-4 years.
authors.affiliation: Department of Pediatric Nephrology, St. John's Medical College Hospital Bangalore, E10/2 Vijay Kiran Apartments, 32 Victoria Road, Bangalore, 560047, Karnataka, India. myths888@gmail.com
authors.forename: Mythili K
authors.initials: MK
authors.lastname: D'Souza
authors.forename: Namita S
authors.initials: NS
authors.lastname: Verma
authors.forename: Prasanna Kumar
authors.initials: PK
authors.lastname: A R
authors.forename: Kanishka
authors.initials: K
authors.lastname: Das
authors.forename: Kishore D
authors.initials: KD
authors.lastname: Phadke
authors.forename: Arpana
authors.initials: A
authors.lastname: Iyengar
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007668:Kidney / Q000000981:diagnostic imaging; D008297:Male; D014463:Ultrasonography; D014513:Ureter / Q000000981:diagnostic imaging*; D014552:Urinary Tract Infections / Q000150:complications; D014554:Urination / Q000502:physiology; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000000981:diagnostic imaging*; D058067:Wavelet Analysis