Study Of Prevalence Of Vesicoureteric Reflux And Renal Scarring In Children With Urinary Tract Infection

Dr Sruthi Yechuri; Dr M Bala Gopal; Dr M Vaishnavi; Dr Arjama Thakur

doi:10.69980/ajpr.v28i5.378

Authors

Dr Sruthi Yechuri
Dr M Bala Gopal
Dr M Vaishnavi
Dr Arjama Thakur

DOI:

https://doi.org/10.69980/ajpr.v28i5.378

Keywords:

Urinary Tract Infections, Vesico-Ureteral Reflux, Kidney, Renal Scarring, Dimercaptosuccinic Acid, Voiding Cystourethrography, Child, Pyelonephritis, Risk Factors, Ultrasonography

Abstract

Objective: To determine the prevalence of vesicoureteric reflux (VUR) and renal scarring in children with urinary tract infection (UTI) and identify associated risk factors.

Methods: A cross-sectional observational study was conducted on 50 children (aged 0-12 years) with confirmed UTI at a tertiary care hospital from January 2023 to December 2024. All children underwent renal-bladder ultrasonography, voiding cystourethrogram (VCUG), and dimercaptosuccinic acid (DMSA) renal scintigraphy. VUR was graded according to the International Reflux Study Committee classification, and renal scarring was defined as persistent defects on follow-up DMSA scan performed 6 months after the acute infection. Risk factors for renal scarring were identified using multivariate logistic regression analysis.

Results: The study population comprised 36 females (72%) and 14 males (28%), with most children (46%) aged 1-5 years. The overall prevalence of VUR was 42%, with unilateral reflux (26%) being more common than bilateral reflux (16%). VUR prevalence was highest in infants under 1 year (55.6%) and decreased with age. Renal scarring was detected in 34% of children, with unilateral scarring (70.6%) predominating. A strong association was found between VUR and renal scarring (61.9% vs. 13.8%, p<0.001), with all children with high-grade VUR (Grades III-V) developing renal scarring compared to only 27.3% with low-grade VUR. Multivariate analysis identified high-grade VUR (OR: 8.7, p<0.001), recurrent UTIs (OR: 3.2, p=0.001), age less than 1 year (OR: 2.8, p=0.003), and delayed antibiotic treatment (OR: 2.5, p=0.015) as significant independent risk factors for renal scarring.

Conclusion: VUR and renal scarring are common in children with UTI, with a significant association between high-grade reflux and permanent renal damage. Early diagnosis and prompt treatment of UTIs are critical, especially in high-risk groups, to prevent long-term renal sequelae.

Author Biographies

Dr Sruthi Yechuri

Postgraduate Student, Department Of Pediatrics, Meenakshi Medical College And Research Institute, Meenakshi Academy Of Higher Education And Research, Kanchipuram, Tamil Nadu

Dr M Bala Gopal

Professor, Department Of Pediatrics, Meenakshi Medical College And Research Institute, Meenakshi Academy Of Higher Education And Research, Kanchipuram, Tamil Nadu

Dr M Vaishnavi

Postgraduate Student, Department Of Pediatrics, Meenakshi Medical College And Research Institute, Meenakshi Academy Of Higher Education And Research, Kanchipuram, Tamil Nadu

Dr Arjama Thakur

Postgraduate Student, Department Of Pediatrics, Meenakshi Medical College And Research Institute, Meenakshi Academy Of Higher Education And Research, Kanchipuram, Tamil Nadu

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