Subject: childhood vesicoureteral reflux
Subject: chronic renal failure
Subject: predictive risk factors
Subject: renal dysfunction
Year: 2019
Type: Article
Title: Predictors of Renal Dysfunction in Adults with Childhood Vesicoureteral Reflux after Long-Term Follow-Up
Author: Smiljana Bundovska-Kocev
Author: Dafina Kuzmanovska
Author: Gjulsen Selim
Author: Ljibica Georgievska-Ismail
Abstract: BACKGROUND:Triad of childhood vesicoureteral reflux (VUR), urinary infection (UTI) and renal scarring might initiate potentially serious consequences that lead to renal dysfunction manifested at the second or third decade of life.AIM:To identify the risk factors predictive for renal dysfunction in adults with primary VUR after long-term follow-up. METHODS:We evaluated the records of 101 children (94.1% female, 5.9% male) at a medianage of 5.2± 2.3 years (1-12 years), suffering from UTI and VUR. The patients were interviewedafter mean 21 years from the first episodes of VUR (8 to 32 years). Renal function was determinedfrom the estimated glomerular filtration rate (eGFR).RESULTS:Renal scarring was detected in 68.3% out of 82 patients and bilateral one in 7.3% patients. Linear regression analysis revealed that presence of proteinuria (B = -33.7, p=0.0001), the greater number of years from VUR diagnosis (B = -1.6, p = 0.002) and renal scarring (B = -14.8, p = 0.005) appeared as independent predictors of reduced global eGFRcreat. The same variables plus microalbuminuria (B = -1.0,p = 0.012) appeared as independent predictors of reduced global eGFRcreat-cys. Bilateral scarring (OR=25.5,p = 0.003) appeared as independent predictor of greater risk for CKD assessed using eGFRcreat while greater number of years from VUR diagnosis (OR = 1.7, p = 0.092), microalbuminuria (OR = 1.3, p = 0.047) and again bilateral scarring (OR = 31.3, p = 0.040) appeared as predictors of risk for CKD assessed using eGFRcreat-cys. CONCLUSION:Identification of those with an increasedrisk of progression toCKD should be the goal in all patients with childhood VUR. Their systematic follow-up should be till adulthood and older age.
Publisher: ID-Design/Scientific foundation SPIROSKI
Relation: Open Access Macedonian Journal of Medical Sciences
Identifier: oai:repository.ukim.mk:20.500.12188/12635
Identifier: http://hdl.handle.net/20.500.12188/12635Identifier: https://doi.org/10.3889/oamjms.2019.078
