Jornal de Pediatria
On-line version ISSN 1678-4782
MACEDO, Célia S.; RIYUZO, Márcia C. and BASTOS, Herculano D.. Renal scars in children with primary vesicoureteral reflux. J. Pediatr. (Rio J.) [online]. 2003, vol.79, n.4, pp. 355-362. ISSN 1678-4782. http://dx.doi.org/10.1590/S0021-75572003000400015.
OBJECTIVE: to determine the incidence of renal scars in children with primary vesicoureteral reflux taking into consideration the following variables: sex, age at diagnosis, febrile urinary infection, degree of reflux and bacteria specimen. METHOD: retrospective study of 58 children with age ranging from 2 months to 11 years, presenting primary vesicoureteral reflux detected by voiding cystourethrogram after documented episode of urinary tract infection. The diagnosis of renal scarring was obtained by dimercaptosuccinic acid scan 5 months after the treatment of the urinary infection; in 40 children the dimercaptosuccinic acid scan was performed again from 6 months up to 6 years after the treatment. RESULTS: 45 children (77.6%) were girls and 13 (22.4%) were boys, 51.7% were 2 years old or younger. The incidence of renal scarring was 55.2%. There was significant higher proportion of renal scars in girls, when the patients presented fever and dilated vesicoureteral reflux (III, IV, V). Fever and female sex were risk factors for the development of renal scars (fever - ODDS ratio = 6.19 and female sex - ODDS ratio = 4.12). There was a prevalence of renal scars in children over 2 years old. The interval between the beginning of the symptoms and the first medical visit was longer in the children with renal scars. New renal scars were observed in 12.5%. CONCLUSIONS: fever and female sex were risk factors for the presence of renal scars, mainly in the dilated vesicoureteral reflux. The high incidence of renal scars in this study may be related to delayed diagnosis of vesicoureteral reflux.
Keywords : primary vesicoureteral reflux; renal scar.