Spontaneous Vesicoureteral Reflux Resolution among Infants Aged Less Than One Year

Vesicoureteral reflux (VUR) followed by urinary tract infection (UTI) is a major contributing factor to kidney failure, especially during early childhood. This study aimed to evaluate the possibility of spontaneous high-grade VUR resolution in infants aged less than one year.
This cross-sectional study was conducted at Amirkola Children’s Hospital of Babol, Iran on all the infants aged less than one year with high-grade VUR (III-V). Infants were followed-up in terms of at least one kidney per age, reflux grade, and kidney failure for two years. Evaluation of reflux resolution was performed using voiding cystourethrography (VCUG) and radionuclide cystography (RNC) each year. In addition, presence of kidney failure was assessed via dimercaptosuccinic acid (DMSA) scan within at least 4-6 months after the last UTI diagnosis. Data analysis was performed in SPSS V.22 using Chi-square and Kaplan-Meier survival analysis, and P value of less than 0.05 was considered statistically significant.
FINDINGS: In total, 97 kidneys in 49 infants were evaluated (one infant had only one kidney). Among the studied patients, 29 infants (59.2%) were female, and mean age of the study population was 5.9±3.66 months. Out of 49 infants with VUR, complete recovery was observed in 33 cases (67.3%), while partial resolution (reduced grade of reflux) was reported in 13 cases (26.5%), and lack of resolution was observed in 3 cases (6.1%).
According to the results of this study, spontaneous resolution of high-grade VUR could occur in a high percentage of infants aged less than one year. Therefore, it is recommended that early surgical operation be reconsidered for this patient population