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Journal of the Korean Society of Pediatric Nephrology 1998;2(2): 152-160.
방광요관역류의 완해에 영향을 미치는 인자에 관한 연구
송병호, 오창원, 김기복
1광주기독병원 소아과
2광주기독병원 소아과
3광주기독병원 소아과
A Clinical Study on Factors affecting Spontaneous Resolution of Vesicoureteral ,Reflux in Children
Byung-Ho Song, Chang-Weon Oh, Ki-Bok Kim
1Department of Pediatrics, Kwangju Christian Hospital
2Department of Pediatrics, Kwangju Christian Hospital
3Department of Pediatrics, Kwangju Christian Hospital
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ABSTRACT
Purpose : Vesicoureteral reflux (VUR), which can result in renal failure in children, is expected to resolve spontaneously in mild cases, but severe cases require surgical correction, posing dilemma in deciding the right measures in some cases. Therefore, to delineate the factors affecting spontaneous resolution of VUR and to apply them in assessing the prognosis, we reviewed the patients with VUR who had been treated medically.
Patients and Methods : 32 children (49 renal units) with reflux who had been admitted during the 5-year period from Jan '92 to Dec '96 were classified into 4 groups (Resolved, Improved, Unchanged, and Worsened) and analyzed.
Results : 1) 25 were boys and 7 girls. The age at diagnosis ranged from 13 days to 9 years (mean $24.6{pm}11.4$ mo) 2) Among 49 refluxing ureters, 4 were below 1 me of age,21 between 1 me to 1 yr, 16 between 1 yr to 6 yr, 8 beyond 6 yr. Two belonged to Grade I, 16 to Crade II, 17 to Grade III, 12 to Grade IV, and 2 to Grade V. 3) Spontaneous resolution rates of reflux were 100, 81, 47, 8, 0$%$ for each Grade, respectively. Resolution plus improvement rates in Grade III and IV were 71 and $50%$, each. 4) Resolution rates in relation to the age at diagnosis were $100%$ for below 1 mo, $48%$ between 1 mo to 1 yr, $56%$ between 1 to 6 yr, and $13%$ beyond 6 yr. 5) Of 15 unilateral refluxing ureters, 14 ($93%$) resulted in resolution. Of 34 bilateral refluxing ureters, 11 ($32%$) resolved spontaneously 6) Resolution occurred within 1 year in 20 units of 24 renal units in regular follow-up.
Conclusion : The lower the initial grade and the younger the patient, the sooner the reflux resolved. Resolution was better when VUR was unilateral than bilateral. Long-term regular follow-up is essential because even the cases falling in Grades III and IV have high rates of spontaneous resolution and improvement with medical treatment.
Key words: Vesicoureteral Reflux | VUR Resolution | VUR Improvement
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