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Saudi Journal of Kidney Diseases and Transplantation
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ORIGINAL ARTICLE Table of Contents   
Year : 2009  |  Volume : 20  |  Issue : 1  |  Page : 57-68
Evaluating kidney damage from vesico-ureteral reflux in children


1 Department of Mother-Child and Biology-Genetics, University of Verona, Italy
2 Hymmonohematology and Transfusion Service, University of Parma, ParmaTransfusion Service, Verona Hospital, Verona, Italy
3 Department of Pediatrics and Clinical Medicine, Section of Neonatal Intensive Care Unit, University of Cagliari, Cagliari, Italy

Correspondence Address:
M Zaffanello
Department of Mother-Child and Biology-Genetics, University of Verona, Piazzale L. Scuro, 10 37134 Verona
Italy
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PMID: 19112220

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To review the most relevant clinical studies that evaluate kidney damage in children with primary vesico-ureteral reflux (VUR), we reviewed and compared randomized controlled trials and clinical trials from scientific literature. In these studies, vesico-ureteral reflux was diagnosed by voiding cystourethrogram and kidney damage was assessed by either DMSA scan or urography. Relative risk with 95% confidence intervals was calculated using Review Manager Software (The Cochrane Collaboration, 2000). The overall relative risk of kidney damage shown by DMSA scan and urography was statistically higher in children with vesico-ureteral reflux of various degrees than in controls (3.7 times and 2.8 times, respectively). However, in high-grade VUR, the relative risk of congenital kidney damage was 5.6 times that of controls. We conclude that severe VUR is frequently associated with early kidney damage, perhaps with prenatal onset. Progression of kidney damage may depend on the severity of VUR and untreated urinary tract infections. Prevention of congenital kidney damage from severe VUR is possible when there is early intervention, even during fetal growth.


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