Contemporary incidence of morbidity related to vesicoureteral reflux. Commentary. Authors'reply.
The association among vesicoureteral reflux (VUR), renal scarring, and reflux nephropathy is well established.
Screening programs for children who present with urinary tract infection (UTI) and their siblings, along with medical and surgical management, have been promoted by pediatric medical and urologic specialists in Buffalo and the surrounding community for more than two decades.
Has this comprehensive and costly effort resulted in a decrease in VUR-related morbidity and should it be continued ?
The records of all active patients who presented from 1982 through 1997 to this region's single pediatric nephrology referral center were reviewed.
One hundred twenty-two children and adolescents (73 boys, 49 girls) were identified with hypertension (HTN), renal insufficiency (RI), and end-stage renal disease (ESRD) requiring dialysis or transplantation.
There were 70 patients (57%) with HTN, 19 (16%) with RI, and 33 (27%) with ESRD.
Reflux nephropathy was the underlying cause in 6 patients (5%) - 3 with HTN and 3 with ESRD.
The etiologies of morbidity in the remaining patients were medical renal disease, 61 (50%) ; idiopathic, 17 (14%) ; obstructive uropathy, 14 (11%) ; primary congenital renal hypoplasia, 12 (10%) ; and vascular, 12 (10%). Of the 6 patients with VUR-related morbidity, 4 were boys (3 with ESRD, 1 with HTN) and 2 were girls (with HTN).
Five children presented in the 1980s and 1 in the 1990s. (...)
Mots-clés Pascal : Reflux vésicourétéral, Enfant, Homme, Association morbide, Hypertension artérielle, Epidémiologie, Aide diagnostic, Insuffisance rénale, Dépistage, Morbidité, Rapport coût bénéfice, Etats Unis, Amérique du Nord, Amérique, Appareil urinaire pathologie, Voie urinaire pathologie, Vessie pathologie, Appareil circulatoire pathologie, Rein pathologie
Mots-clés Pascal anglais : Vesicoureteral reflux, Child, Human, Concomitant disease, Hypertension, Epidemiology, Diagnostic aid, Renal failure, Medical screening, Morbidity, Cost benefit ratio, United States, North America, America, Urinary system disease, Urinary tract disease, Bladder disease, Cardiovascular disease, Kidney disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0212273
Code Inist : 002B14C02. Création : 16/11/1999.