Saudi Journal of Kidney Diseases and Transplantation

: 1997  |  Volume : 8  |  Issue : 1  |  Page : 43--44

Authors' Reply

Othman A Al Mohrij, Abdullah A Al Zaben, Saud Al Rasheed 
 Department of Pediatrics, King Fahad National Guard Hospital, P.O. Box 22490, Riyadh 11426, Saudi Arabia

Correspondence Address:
Othman A Al Mohrij
Department of Pediatrics, King Fahad National Guard Hospital, P.O. Box 22490, Riyadh 11426
Saudi Arabia

How to cite this article:
Al Mohrij OA, Al Zaben AA, Al Rasheed S. Authors' Reply.Saudi J Kidney Dis Transpl 1997;8:43-44

How to cite this URL:
Al Mohrij OA, Al Zaben AA, Al Rasheed S. Authors' Reply. Saudi J Kidney Dis Transpl [serial online] 1997 [cited 2020 Oct 19 ];8:43-44
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Full Text

We would like to thank the reader for raising some very valuable points, all of which, should certainly be taken into account and implemented if the study of VUR is done in a prospective manner.

It was not the goal of the article to evaluate the exact incidence or prevalence of vesicoureteric reflux (VUR) in children. We agree that the true frequency of the problem cannot be ascertained by analyzing only those patients discharged with the diagnosis of VUR. The aim was to shed some light on the problem of the pathology, clinical course and management of children diagnosed to have VUR. With respect to the questions raised:

1. "The urological admissions" are those patients admitted under care of a pediatric urologist to evaluate the possibility of underlying urological anomalies including hydronephrosis, congenital obstructive uropathies like posterior urethral valves, neurogenic bladder and dysfunctional voiding syndrome. Urinary tract infection is usually managed by the general physician or pediatrician and therefore not all patients with this diagnosis were included. This is the main diagnosis to be included if the aim is to pick-up most of the children with VUR.

2. As DMSA scanning has become available only recently in the hospital, only 10 patients had the investigation done once. It was for this reason that the incidence of renal scars in our patients could not be assessed.

3. The main indication for ureteral reimplantation in this series was severe reflux (grades IV & V) with breakthrough infection or because the child resided far away from a medical facility making frequent follow-up and monitoring difficult.

4. VCUG was done on an yearly basis to assess the progress or resolution of VUR. We agree that follow-up of such patients with radioisotope VCUG is a better alternative to reduce radiation exposure.