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J Urol. 2010 Jul;184(1):292-7. doi: 10.1016/j.juro.2010.01.060. Epub 2010 May 23.

The Swedish reflux trial in children: IV. Renal damage.

Author information

1
Pediatric Uro-Nephrologic Center, The Queen Silvia Children's Hospital, University of Gothenburg, Göteborg, Sweden.

Abstract

PURPOSE:

We compared the development of new renal damage in small children with dilating vesicoureteral reflux randomly allocated to antibiotic prophylaxis, endoscopic treatment or surveillance as the control group.

MATERIALS AND METHODS:

Included in the study were 128 girls and 75 boys 1 to younger than 2 years with grade III-IV reflux. Voiding cystourethrography and dimercapto-succinic acid scintigraphy were done before randomization and after 2 years. Febrile urinary tract infections were recorded during followup. Data analysis was done by the intent to treat principle.

RESULTS:

New renal damage in a previously unscarred area was seen in 13 girls and 2 boys. Eight of the 13 girls were on surveillance, 5 received endoscopic therapy and none were on prophylaxis (p = 0.0155). New damage was more common in children with than without febrile recurrence (11 of 49 or 22% vs 4 of 152 or 3%, p <0.0001).

CONCLUSIONS:

In boys the rate of new renal damage was low. It was significantly higher in girls and most common in the control surveillance group. There was also a strong association between recurrent febrile UTIs and new renal damage in girls.

Comment in

PMID:
20494369
DOI:
10.1016/j.juro.2010.01.060
[Indexed for MEDLINE]

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