J Korean Soc Pediatr Nephrol.  2011 Oct;15(2):179-183.

A Case with Abrupt Progression of Renal Scarring or Abrupt Deterioration of Renal Function Associated with Vesicoureteral Reflux

• Kim MK
• Park SE
• Lee JH

Abstract

Abrupt progression of renal scarring associated with vesicoureteral reflux (VUR) is rare in males over 2 years old of age. We report a 5 year old boy with sustained unilateral high grade VUR who experienced abrupt progression of renal scarring; he had a relative renal radionuclide uptake of 38% at 2 years of age that dropped to 8% after three years. Per his parent's wishes, he took prophylactic antibiotics for 25 months after his first febrile urinary tract infection (UTI) at 4 months old without surgical management. One episode of recurrent breakthrough infection occurred at the age of 2 years. This observation reminds us that a recommending surgical management for sustained high grade VUR associated with renal scarring might be needed. Close follow up of DMSA for renal scanning, and long term follow up of patients after the first febrile UTI are important.

Keyword

Dimercaptosuccinic acid renal scan; High grade vesicoureteral reflux; Renal scarring; Urinary tract infection

MeSH Terms

Anti-Bacterial Agents
Cicatrix
Follow-Up Studies
Humans
Male
Succimer
Urinary Tract Infections
Vesico-Ureteral Reflux
Anti-Bacterial Agents
Succimer