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Risk factors for renal scarring and deterioration of renal function in primary vesico-ureteral reflux children: a long-term follow-up retrospective cohort study.

Chen MJ, Cheng HL, Chiou YY - PLoS ONE (2013)

Bottom Line: Univariate and multivariate models were applied to identify the corresponding independent predictors.A total of 173 patients with primary VUR were recruited.The median age of VUR diagnosis was 10.0 months (IQR: 4.0-43.0 months).

View Article: PubMed Central - PubMed

Affiliation: Department of Long Term Care, Chung Hwa University of Medical Technology, Rende Shiang, Tainan County, Taiwan, Republic of China.

ABSTRACT

Background and purpose: The aim was to identify the risk factors for renal scarring and deteriorating renal function in children with primary vesico-ureteral reflux (VUR).

Materials and methods: Patients with primary VUR admitted to the National Cheng Kung University Hospital were retrospectively analyzed. The outcomes were renal scarring, assessed by technetium-99 m dimercaptosuccinic acid scanning, and renal function, assessed by estimated glomerular filtration rate. Univariate and multivariate models were applied to identify the corresponding independent predictors.

Results: A total of 173 patients with primary VUR were recruited. The median age of VUR diagnosis was 10.0 months (IQR: 4.0-43.0 months). After adjusting for confounding factors, it was found that older age of VUR diagnosis (≥5 years vs. <1 year, adjusted OR = 2.78, 95% CI = 1.00-7.70, p = 0.049), higher grade of VUR (high grade [IV-V] vs. none, adjusted OR = 15.17, 95% CI = 5.33-43.19, p<0.0001; low grade [I-III] vs. none, adjusted OR = 5.72, 95% CI = 2.43-13.45, p<0.0001), and higher number of UTI (≥2 vs. 0, adjusted OR = 3.21, 95% CI = 1.06-9.76, p = 0.039) were risk factors for renal scarring, whereas a younger age of VUR diagnosis (≥5 years vs. <1 year, adjusted HR = 0.16, 95% CI: 0.05-0.51, p = 0.002), renal scarring (yes vs. no, adjusted HR = 3.66, 95% CI: 1.32-10.16, p = 0.013), and APN (yes vs. no, adjusted HR = 3.10, 95% CI: 1.05-9.14, p = 0.041) were risk factors for developing chronic kidney disease stage 2 or higher.

Conclusions: Our findings expand on the current knowledge of risk factors for renal scarring and deteriorating renal function, and this information can be used to modify the management and treatment of VUR.

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Kaplan-Meier survival curves for the development of renal failure (i.e. chronic kidney disease [CKD] stage 2 or higher) according to the grade and location (i.e. unilateral vs. bilateral) of primary vesico-ureteral reflux (VUR) (log-rank test, P  = 0.055).
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pone-0057954-g001: Kaplan-Meier survival curves for the development of renal failure (i.e. chronic kidney disease [CKD] stage 2 or higher) according to the grade and location (i.e. unilateral vs. bilateral) of primary vesico-ureteral reflux (VUR) (log-rank test, P  = 0.055).

Mentions: Furthermore, of the 173 patients, 138 had a record of CKD stage at last visit. Patients were evaluated according to the following four groups of primary VUR: 1) unilateral, low grade (n = 48); 2) unilateral, high grade (n = 18); 3) bilateral, low grade (n = 30); and 4) bilateral, high grade (n = 42). It should be noted that patients with the presence of bilateral VUR and a high grade of VUR in either kidney were grouped in the ‘bilateral, high grade’ group. The renal survival curves for these four primary VUR groups are presented in Figure 1. However, the renal survival curves did not differ significantly among the groups (log-rank test, p = 0.055).


Risk factors for renal scarring and deterioration of renal function in primary vesico-ureteral reflux children: a long-term follow-up retrospective cohort study.

Chen MJ, Cheng HL, Chiou YY - PLoS ONE (2013)

Kaplan-Meier survival curves for the development of renal failure (i.e. chronic kidney disease [CKD] stage 2 or higher) according to the grade and location (i.e. unilateral vs. bilateral) of primary vesico-ureteral reflux (VUR) (log-rank test, P  = 0.055).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585242&req=5

pone-0057954-g001: Kaplan-Meier survival curves for the development of renal failure (i.e. chronic kidney disease [CKD] stage 2 or higher) according to the grade and location (i.e. unilateral vs. bilateral) of primary vesico-ureteral reflux (VUR) (log-rank test, P  = 0.055).
Mentions: Furthermore, of the 173 patients, 138 had a record of CKD stage at last visit. Patients were evaluated according to the following four groups of primary VUR: 1) unilateral, low grade (n = 48); 2) unilateral, high grade (n = 18); 3) bilateral, low grade (n = 30); and 4) bilateral, high grade (n = 42). It should be noted that patients with the presence of bilateral VUR and a high grade of VUR in either kidney were grouped in the ‘bilateral, high grade’ group. The renal survival curves for these four primary VUR groups are presented in Figure 1. However, the renal survival curves did not differ significantly among the groups (log-rank test, p = 0.055).

Bottom Line: Univariate and multivariate models were applied to identify the corresponding independent predictors.A total of 173 patients with primary VUR were recruited.The median age of VUR diagnosis was 10.0 months (IQR: 4.0-43.0 months).

View Article: PubMed Central - PubMed

Affiliation: Department of Long Term Care, Chung Hwa University of Medical Technology, Rende Shiang, Tainan County, Taiwan, Republic of China.

ABSTRACT

Background and purpose: The aim was to identify the risk factors for renal scarring and deteriorating renal function in children with primary vesico-ureteral reflux (VUR).

Materials and methods: Patients with primary VUR admitted to the National Cheng Kung University Hospital were retrospectively analyzed. The outcomes were renal scarring, assessed by technetium-99 m dimercaptosuccinic acid scanning, and renal function, assessed by estimated glomerular filtration rate. Univariate and multivariate models were applied to identify the corresponding independent predictors.

Results: A total of 173 patients with primary VUR were recruited. The median age of VUR diagnosis was 10.0 months (IQR: 4.0-43.0 months). After adjusting for confounding factors, it was found that older age of VUR diagnosis (≥5 years vs. <1 year, adjusted OR = 2.78, 95% CI = 1.00-7.70, p = 0.049), higher grade of VUR (high grade [IV-V] vs. none, adjusted OR = 15.17, 95% CI = 5.33-43.19, p<0.0001; low grade [I-III] vs. none, adjusted OR = 5.72, 95% CI = 2.43-13.45, p<0.0001), and higher number of UTI (≥2 vs. 0, adjusted OR = 3.21, 95% CI = 1.06-9.76, p = 0.039) were risk factors for renal scarring, whereas a younger age of VUR diagnosis (≥5 years vs. <1 year, adjusted HR = 0.16, 95% CI: 0.05-0.51, p = 0.002), renal scarring (yes vs. no, adjusted HR = 3.66, 95% CI: 1.32-10.16, p = 0.013), and APN (yes vs. no, adjusted HR = 3.10, 95% CI: 1.05-9.14, p = 0.041) were risk factors for developing chronic kidney disease stage 2 or higher.

Conclusions: Our findings expand on the current knowledge of risk factors for renal scarring and deteriorating renal function, and this information can be used to modify the management and treatment of VUR.

Show MeSH
Related in: MedlinePlus