The relative function of damaged kidneys in children does not deteriorate further at 3-year follow-up.
OBJECTIVE
It is thought that the function of a damaged kidney will deteriorate further with time because of impaired maturation and compensatory hyperfiltration. The aim of this study was to determine changes in relative renal function (RRF) over time in children with vesicoureteric reflux (VUR) and/or urinary tract infection (UTI) where the unilaterally scarred kidney was found to contribute 30% or less to overall function.


METHODS
Children who met the inclusion criteria and had multiple radionuclide studies during a 12-year period were identified, and RRF was compared.


RESULTS
Twenty-seven boys and 3 girls with a median age of 0.8 years (0.08-13.05 years) were included. Eight patients had unilateral VUR, 21 patients had bilateral VUR, and 1 patient had UTIs without VUR. Twenty-one patients underwent reimplantation surgery, and 9 were managed conservatively.At a mean follow-up of 2.64 years (0.26-6.77 years), there was a nonsignificant mean decrease in RRF from 19% (11%-28%) to 18% (9%-29%). The mean change in renal function was not affected by the severity of the initial RRF.


CONCLUSIONS
In the medium term, there is no deterioration of RRF of unilaterally severely damaged kidneys associated with either VUR or UTI managed either surgically or conservatively. Boys are at a much greater risk of severe reflux nephropathy.
From the *Sydney Children's Hospital; and †Prince of Wales Hospitals, Randwick; and ‡University of New South Wales, Sydney, New South Wales, Australia.
Amy
A
Whittaker
Maria
M
Moon
Grant
G
Mitchell
Bruce
B
McBride
Monica A
MA
Rossleigh
Andrew R
AR
Rosenberg
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012737:Sex Factors; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000503:physiopathology*
D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid