J Korean Soc Pediatr Nephrol.  2007 Apr;11(1):74-82.

Spontaneous Resolution Rate and Predictive Factors of Resolution in Children with Primary Vesicoureteral Reflux

• Kang EY
• Kim MS
• Kwon KS
• Lee DY
• Park EH

Abstract

PURPOSE: To analyze the clinical characteristics, spontaneous resolution rate and predictive factors of resolution in children with primary vesicoureteral reflux(VUR).
METHODS
Between October 1991 and July 2003, 149 children diagnosed with primary VUR at Chonbuk National University Hospital were reviewed retrospectively. All of the patients were maintained on low-dose antibiotic prophylaxis and underwent radionuclide cystograms at 1- year intervals over 3 years after the initial diagnosis of VUR by voiding cystourethrogram was made.
RESULTS
The median time to resolution of VUR was 24 months and the total 3 year-cumulative resolution rate of VUR was 61.7%. The following variables were associated with resolution of VUR according to univariate analysis-; age<1 year, male gender, mild grade of reflux, unilateral reflux, congenital hydronephrosis as clinical presentation at time of diagnosis of VUR, absence of focal defects in the renal scan at diagnosis, absence of recurrent UTI, renal scars and small kidney during follow-up. After adjustment by Cox regression model, five variables remained as independent predictors of VUR resolution; age<1 year, relative risk 1.77(P<0.05), VUR grade I+II 2.98(P<0.05), absence of renal scars 2.23(P<0.05), and absence of small kidney 5.20(P<0.01) during follow-up.
CONCLUSION
In this study, spontaneous resolution rate of VUR, even high grade reflux, is high in infants during medical management, and it was related to age, reflux grade at diagnosis, absence of renal scars and small kidney during follow-up. Therefore early surgical intervention should be avoided and reserved for the selected groups.

Keyword

Vesicoureteral reflux; Urinary tract infection; Renal scar; Resolution

MeSH Terms

Antibiotic Prophylaxis
Child*
Cicatrix
Diagnosis
Follow-Up Studies
Humans
Hydronephrosis
Infant
Jeollabuk-do
Kidney
Male
Retrospective Studies
Urinary Tract Infections
Vesico-Ureteral Reflux*