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Therapeutic Management of Children with Vesicoureteral Reflux.
Chirico, Valeria; Tripodi, Filippo; Lacquaniti, Antonio; Monardo, Paolo; Conti, Giovanni; Ascenti, Giorgio; Chimenz, Roberto.
Afiliação
  • Chirico V; Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy.
  • Tripodi F; Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy.
  • Lacquaniti A; Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy.
  • Monardo P; Nephrology and Dialysis Unit, Papardo Hospital, 98158 Messina, Italy.
  • Conti G; Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy.
  • Ascenti G; Section of Radiological Sciences, Department of Biomedical Sciences and Morphological and Functional Imaging, University Hospital "G. Martino", 98124 Messina, Italy.
  • Chimenz R; Pediatric Nephrology and Dialysis Unit, University Hospital "G. Martino", 98124 Messina, Italy.
J Clin Med ; 13(1)2023 Dec 31.
Article em En | MEDLINE | ID: mdl-38202251
ABSTRACT
Contrasting data refer to therapies for vesicoureteral reflux (VUR), such as surgical treatments and continuous antibiotic prophylaxis (CAP). This study evaluated the effectiveness of these approaches in children with VUR, analyzing the recurrence of febrile urinary tract infections (UTIs) and the resolution of VUR after the treatment. A total of 350 pediatric patients underwent contrast-enhanced voiding urosonography (ceVUS) to diagnose a VUR, whereas renal scintigraphy evaluated potential scars. After 12 months from the treatment, the VUR, the relapse of febrile UTIs, and reflux-related nephropathy were analyzed. Twenty-seven children had recurrent febrile UTIs after surgical therapy, with a greater rate of relapses observed in III and V VUR grades. Thirteen patients who underwent surgery had scars, independently of VUR grades and gender, with evidence of chronic renal failure at the end of the follow-up period. A total of 140 subjects were treated with CAP, and 30% of them continued to suffer from febrile UTIs. Ninety-five patients with VUR underwent ceVUS after 12 months, with persistent reflux in fifty-two patients. All of them had severe VUR, correlating with the age at diagnosis and gender. CAP therapy prevented scarring better than surgery, especially in children with III and V grades of VUR. A late onset of VUR or VUR involving neonatal patients is rarely a reversible process. This study identified predictors of success or failure of surgical or CAP therapies, evaluating the relapse of UTIs or persistent reflux after the treatment and giving prognostic information in children with VUR.
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Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Idioma: En Ano de publicação: 2023 Tipo de documento: Article