IMPROVEMENT IN THE GRADE OF VESICOURETERAL REFLUX ON SERIAL VCUG/RNC PREDICTS RESOLUTION: A LONGITUDINAL STUDY OF 1761 CHILDREN WITH VUR

Back to 77th Annual Meeting
Back to Program Outline

Background:
When children are initially diagnosed with vesicoureteral reflux (VUR), most undergo a period of antibiotic prophylaxis followed by serial imaging. There are several factors that affect the probability of VUR resolution. Although one might believe that improvement in grade of reflux over time predicts eventual resolution, the significance of changing grade of reflux over time is unknown. We examined if improvement in VUR on serial imaging predicts eventual resolution.
Methods:
A retrospective review was performed of 1761 children diagnosed with VUR. Initial reflux grade and grade on serial imaging were examined up to 5 years after the original diagnosis. For each subsequent imaging study reflux was defined as improved, without change, or worsened. For each of these groups it was determined whether the child’s reflux resolved, eventually resolved, never resolved and underwent surgery, or never resolved and did not undergo surgery. The groups were further stratified by age and sex.
Results:
Of the 1761 children diagnosed with VUR, 82% were female and 80% presented with UTI. 28% experienced resolution of VUR on imaging studies one year after diagnosis. Rates of reflux resolution and rates of improvement, lack of change, and worsening reflux on follow-up imaging are listed in Table 1 for 1st and 2nd year follow-up (additional years not listed due to limited space).
Conclusion:
For the children with unresolved VUR 1 year after diagnosis, improvement in reflux grade on 1st-year follow-up imaging is associated with high rate of VUR resolution on 2nd-year follow-up imaging studies. However, it should be noted that improvement in VUR grade in the 1st-year follow up does not necessarily imply resolution, since 30% of patients who did not resolve during the 2nd year also had improvement. The data from this study will be useful when counseling families about the probability of VUR resolution over time after their initial period of observation.

Back to 77th Annual Meeting
Back to Program Outline