Clinical Course of 250 Pediatric Cases of Vesicoureteral Reflux in Zahedan, Southeast of Iran

Although the incidence of primary reflux is 0.1-1.3% in the general population, it is much higher (29-50%) in children with urinary tract infection (UTI). This study aimed to evaluate the epidemiologic characteristics and outcome of vesicoureteral reflux (VUR) in Iranian children in Zahedan, southeast of Iran.
In this historical cohort study, we reviewed all records of 250 patients diagnosed with VUR who were referred to a Pediatric Nephrology Clinic in Zahedan, Iran between April 2008 and September 2009 and were followed until June 2011. The diagnosis of VUR was made by convectional voiding cystourethgraphy (VCUG). Following the diagnosis, patients received prophylactic low-dose oral antibiotic and were followed by radionuclide cystography (RNC) for 18 months.
Of 250 patients with VUR, 153 (61.2%) were female with a mean age of 2.7 ±2.0 years at presentation. One hundred and thirty patients (52%) had unilateral VUR and 120 patients (48%) had bilateral VUR. In 54.4% of the patients, VUR was detected during the investigation for UTI and 13.2% had prenatal hydronephrosis. Voiding dysfunction was the most important condition with VUR (15.2%). Kidney ultrasound confirmed abnormal results in 73.2% of the patients. Renal scaring secondary to VUR was detected in 85 (34%) patients at the time of VUR diagnosis.
Our data showed that VUR was significantly higher in female children and the frequency of abnormal renal scan was significantly higher in children with high–grade VUR. Further studies may be needed to determine the risk factors and apply effective interventions to minimize the progression of renal damage.