Revista da Associação Médica Brasileira
Print version ISSN 0104-4230
SILVA, José Maria Penido et al. Baseline clinical features of 483 children and adolescents with primary vesicoureteral reflux: a retrospective study. Rev. Assoc. Med. Bras. [online]. 2004, vol.50, n.2, pp. 153-157. ISSN 0104-4230. http://dx.doi.org/10.1590/S0104-42302004000200030.
OBJECTIVES: To evaluate the clinical/radiological features of patients with primary vesicoureteral reflux (VUR) admitted to a single institution from 1969 to 1999. METHODS: At admission, after the institution of chemoprophylaxis, patients were investigated by CUM, DMSA, and US. The children were managed with periodical clinical and laboratory evaluations. Analyses were performed with the data obtained at admission. RESULTS: A total of 483 patients were enrolled in the protocol. There was a predominance of females (70%) and caucasian race (70%). Mean age at VUR diagnosis was 26 months and 92.5% of the patients had urinary infection before admission. A total of 710 refluxing units were analyzed. The distribution of reflux grade was: grade I (49; 7%); II (254; 36%); III (190; 26%); IV (161; 23%) e V (56; 8%). Approximately one half of the units analyzed were from patients presenting renal damage at admission. The distribution of the severity of renal damage was as follows: mild (36%), moderate (34%), and severe (30%). There was a significant risk of severe renal damage for the males (OR = 1.74, 95% CI = 1.2 - 2.5, p = 0.002). CONCLUSION: There was a predominance of VUR among females and most presented a mild or moderate degree. However, there was a high percentage of renal damage at admission and a tendency to greater morbidity for the males.
Keywords : Vesicoureteral reflux; Reflux nephropathy; Risk factors; Children; Adolescents.