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Journal of the Korean Society of Pediatric Nephrology 1997;1(1): 53-59.
일측성 신발생이상 환아에 동반된 반대측 방광요관역류
오성욱, 이재승, 김명준, 한상원, 배기수
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 소아과학교실
3연세대학교 의과대학 진단방사선과학교실
4연세대학교 의과대학 비뇨기과학교실
5아주대학교 의과대학 소아과학교실
Contralateral Vesicoureteral Reflux in Children with Abnormal Unilateral Renal Development
Sung-Wook Oh, Jae-Seung Lee, Myoung-Jun Kim, Sang-Won Han, Ki-Soo Bae
1Departments of Pediatrics, Yonsei University, College of Medicine
2Departments of Pediatrics, Yonsei University, College of Medicine
3Departments of Diagnostic Radiology, Yonsei University, College of Medicine
4Departments of Urology, Yonsei University, College of Medicine
5Departments of Pediatrics, Ajou University, College of Medicine
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ABSTRACT
There have been many recent reports that unilateral renal agenesis and multicystic dysplastic kidneys are accompanied by contralateral vesicoureteral reflux leading to its injury. We grouped the children with unilateral renal agenesis, renal hypoplasia, multicystic dysplastic kidney into abnormal unilateral renal development and investigated whether it was accompanied with contralateral vesicoureteral reflux. We retrospectively reviewed 96 pediatric cases of unilateral renal agenesis, hypoplasia, multicystic dysplastic kidney diagnosed at Shinchon Severance Hospital, Yongdong Severance Hospital from 1987 to 1996 and Ajou University Hospital from 1994 to 1996. Diagnosis was based on radiological findings, renal hypoplasia being defined as small renal size with no apparent renal scarring and no irregularity of the calyceopelvic system on abdominal sonography or intravenous pyelography. Among the 96 cases,48 cases carried out voiding cystourethrography. 58 cases were male(60%) and 38 cases were female(40%). The cases of abnormal unilateral development on the left side were 45(47%) and that on the right side were 51(53%). Although there were diverse reasons leading to diagnosis, the major ones included were prenatal sonography, urinary tract infection, and other congenital anomalies. In cases of unilateral renal agenesis & hypoplasia the leading factors were urinary tract infection & other congenital anomalies and in cases of multicystic dysplastic kidney that was prenatal sonography. There was a chronological gap between the mean age of diagnosis(1.8 year) and voiding cystouerthrography(2.5 year, P < 0.01). 9 of the 18 unilateral renal agenesis cases, 5 of the 11 unilateral renal hypoplasia cases, and 3 of the 19 unilateral multicystic dysplastic kidney cases showed contralateral vesicoureteral reflux. Average reflux grade was above G III.Among the 17 children who had contralateral vesicoureteral reflux, 3 children had chronic renal failure and ureteroneocystostomy was carried out in 6 children. From the above results we conclude that screening voiding cystourethrography should be performed in children with abnormal unilateral renal development for early detection of vesicoureteral reflux in the contralateral kidney.
Key words: Abnormal unilateral renal development | Contralateral | Vesicoureteral reflux
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