Renal Scaring in Infants with Prenatal Hydronephrosis and Vesicoureteral Reflux

Primary vesicoureteral reflux (VUR) is a hereditary disease and the risk of scar increased with VUR. In a few years ago, probability of renal scar formation before delivery and urinary tract infection is suggested. So, this study was done to evaluate this theory and detection of renal scar in neonates with prenatal hydronephrosis and VUR. This cross sectional study was performed on 59 neonates with history of prenatal hydronephrosis. The hydronephrosis were proved after delivery and VCUG (voiding cystourethrography) was done with negative urine cultures. For detection of scar (decrease radioisotope absorption), DMSA (Dimercaptosuccinic Acid) was done in all neonates with VUR. Scar in grade I-V was assessed. This study was done in 59 neonates with history of prenatal hydronephrosis and VUR. Thirty nine (66.1%) neonates were boy and others were girl. Among 116 kidney units, 95 units had VUR and 51 (53.7%) units had scar. Thirsty nine (62%) units with VUR in boys and 12 (37.5%) units in girls had scar (p<0.05). Also, none of units with grade I had scar. Scar in grade II-V was 37.5%, 42.1%, 48.1% and 88.5%, respectively (p<0.05). The existence of high rate scar in these neonates, especially in males and with high grade VUR indicated that early diagnosis and also prevention of UTI and new scare formation is very important.