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Journal of the Korean Society of Pediatric Nephrology 2011;15(2): 179-183. doi: https://doi.org/10.3339/jkspn.2011.15.2.179
고등급의 방광요관역류가 있는 환아에서 급격히 진행된 신반흔
김문규, 박성은, 이준호
1차의과학대학교 분당차병원 소아청소년과
2차의과학대학교 분당차병원 소아청소년과
3차의과학대학교 분당차병원 소아청소년과
A Case with Abrupt Progression of Renal Scarring or Abrupt Deterioration of Renal Function Associated with Vesicoureteral Reflux
Moon-Kyu Kim, Sung-Eun Park, Jun-Ho Lee
1Department of Pediatrics, CHA Bundang Medical Center, CHA University
2Department of Pediatrics, CHA Bundang Medical Center, CHA University
3Department of Pediatrics, CHA Bundang Medical Center, CHA University
Received: July 29, 2011;  Accepted: September 1, 2011.
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Abrupt progression of renal scarring associated with vesicoureteral reflux (VUR) is rare in males over 2 years old of age. We report a 5 year old boy with sustained unilateral high grade VUR who experienced abrupt progression of renal scarring; he had a relative renal radionuclide uptake of 38% at 2 years of age that dropped to 8% after three years. Per his parent's wishes, he took prophylactic antibiotics for 25 months after his first febrile urinary tract infection (UTI) at 4 months old without surgical management. One episode of recurrent breakthrough infection occurred at the age of 2 years. This observation reminds us that a recommending surgical management for sustained high grade VUR associated with renal scarring might be needed. Close follow up of DMSA for renal scanning, and long term follow up of patients after the first febrile UTI are important.
Key words: Dimercaptosuccinic acid renal scan | High grade vesicoureteral reflux | Renal scarring | Urinary tract infection
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