title: Insignificant impact of VUR on the progression of CKD in children with CAKUT.
abstract: BACKGROUND
  Vesicoureteral reflux (VUR) is associated with an increased risk of kidney disorders. It is unclear whether VUR is associated with progression from chronic kidney disease (CKD) to end-stage kidney disease (ESKD) in children with congenital anomalies of the kidney and urinary tract (CAKUT).
  
  
  METHODS
  We conducted a 3-year follow-up survey of a cohort of 447 children with CKD (stage 3-5). Rates of and risk factors for progression to ESKD were determined using the Kaplan-Meier method and Cox regression respectively.
  
  
  RESULTS
  Congenital anomaly of the kidney and urinary tract was the primary etiology in 278 out of 447 children; 118 (42.4 %) had a history of VUR at the start of the cohort study. There were significantly more boys than girls with VUR, whereas the proportions were similar in children without VUR. The types of urinary anomalies/complications of the two groups were significantly different. Three-year renal survival rates of the groups were not significantly different, irrespective of CKD stage. Age  < 2 years and age after puberty, stage 4 or 5 CKD, and heavy proteinuria, but not history of VUR, were significantly associated with progression to ESKD.
  
  
  CONCLUSIONS
  History of VUR at the start of follow-up was not associated with the progression of stage 3-5 CKD in children with CAKUT.
authors.affiliation: Department of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535, Japan. kenzo@ii.e-mansion.com.|Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan. kenzo@ii.e-mansion.com.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishikura
authors.affiliation: Department of Pediatric Nephrology, Aichi Children's Health and Medical Center, Aichi, Japan.|Department of Clinical Medicine, Japanese Red Cross Toyota College of Nursing, Aichi, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Uemura
authors.affiliation: Department of Pediatric Nephrology, Toho University Faculty of Medicine, Tokyo, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hamasaki
authors.affiliation: Department of Pediatric Urology, Jichi Medical University, Children's Medical Center, Tochigi, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Nakai
authors.affiliation: Department of Pediatrics, Yokohama City University Graduate School of Medicine, Kanagawa, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Ito
authors.affiliation: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Ryoko
authors.initials: R
authors.lastname: Harada
authors.affiliation: Department of Pediatric Nephrology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Motoshi
authors.initials: M
authors.lastname: Hattori
authors.affiliation: Department of Integrated Science and Engineering for Sustainable Society, Faculty of Science and Engineering, Chuo University, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.affiliation: Department of Nephrology, Hyogo Prefectural Kobe Children's Hospital, Hyogo, Japan.
authors.forename: Ryojiro
authors.initials: R
authors.lastname: Tanaka
authors.affiliation: Department of Pediatrics, Wakayama Medical University, Wakayama, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Nakanishi
authors.affiliation: Division of Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Kaneko
authors.affiliation: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Kazumoto
authors.initials: K
authors.lastname: Iijima
authors.affiliation: Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Honda
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011627:Puberty; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014564:Urogenital Abnormalities / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality
keywords: Chronic kidney disease; Cohort study; Congenital anomalies of the kidney and urinary tract; End-stage kidney disease; Vesicoureteral reflux