P Orellana1, M E Pizarro, F García, P Baquedano. 1. Departamento de Radiología y Pediatría, Pontificia Universidad Católica de Chile, Santiago, Chile. pilar@med.puc.cl
Abstract
UNLABELLED: Duplex pyeloureteral system (DPS) is common and it can be associated to others anomalies, as vesicoureteral reflux (VUR) in the lower moiety and ureterocele in the upper moiety. The VUR in a DPS can be primary or secondary. Assessment of parenchymal uptake is important. OBJECTIVE: To determine the presence of renal damage (RD) in children with a complete refluxing DS in relationship with clinical presentation and type of VUR. PATIENTS AND METHODS: Retrospectively we evaluated 56 children; 39 girls and 17 boys with an average age of 3.58 years old, with VUR into complete DPS (61 renal units [RU] with DS, 45 of them with primary VUR). Forty-four out of 56 children were evaluated due to urinary tract infection. RESULTS: Twenty-eight out of 61 RU (46 %) had RD. Twenty-one out of 45 RU with primary VUR (46.7 %) had RD and 7 out of 16 RU with secondary VUR had RD (ns). 72.7 % of children with antenatal diagnosis had RD versus 40.8 % of those studied after urinary tract infection (p = 0.04). CONCLUSION: RD is frequent in VUR into complete DPS; 46 % in our experience. There is no significant difference between primary and secondary VUR. RD was more frequent in the group of children with antenatal diagnosis. Renal scintigraphy provides an accurate assessment of the functional renal parenchyma, supporting the therapeutical decision.
UNLABELLED: Duplex pyeloureteral system (DPS) is common and it can be associated to others anomalies, as vesicoureteral reflux (VUR) in the lower moiety and ureterocele in the upper moiety. The VUR in a DPS can be primary or secondary. Assessment of parenchymal uptake is important. OBJECTIVE: To determine the presence of renal damage (RD) in children with a complete refluxing DS in relationship with clinical presentation and type of VUR. PATIENTS AND METHODS: Retrospectively we evaluated 56 children; 39 girls and 17 boys with an average age of 3.58 years old, with VUR into complete DPS (61 renal units [RU] with DS, 45 of them with primary VUR). Forty-four out of 56 children were evaluated due to urinary tract infection. RESULTS: Twenty-eight out of 61 RU (46 %) had RD. Twenty-one out of 45 RU with primary VUR (46.7 %) had RD and 7 out of 16 RU with secondary VUR had RD (ns). 72.7 % of children with antenatal diagnosis had RD versus 40.8 % of those studied after urinary tract infection (p = 0.04). CONCLUSION: RD is frequent in VUR into complete DPS; 46 % in our experience. There is no significant difference between primary and secondary VUR. RD was more frequent in the group of children with antenatal diagnosis. Renal scintigraphy provides an accurate assessment of the functional renal parenchyma, supporting the therapeutical decision.
Authors: H Kelly; C M Molony; J M Darlow; M E Pirker; A Yoneda; A J Green; P Puri; D E Barton Journal: J Med Genet Date: 2007-07-27 Impact factor: 6.318