Incidence and Risk Factors of VUR in Patient with UTI, Nephrology Unit, Tripoli Children Hospital-Libya

Abstract

Vesicoureteral reflux (VUR) is defined as back word flow of urine from the bladder to the ureters. It is a common
finding among children with urinary tract infections (UTIs). The aims of the study are to determine the occurrence
of VUR among children presented to Tripoli Children Hospital with UTI and to find the relationship between VUR
and sex, age, type of UTI, ultrasound (U/S) finding as well as renal scar on DMSA scan.
Retrospectively, from January, 1993 to September, 2008 a total 600 children with documented UTI were included
in this case serious study. Only those who underwent voiding cystourethrography (VCUG) were included,
whereas children with evidence of urinary tract obstruction, neurogenic bladder, presence of renal impairment or
renal stones were excluded.
600 children, 134 (22%) were males and 466 (78%) were females. The mean age is 3.27 ± 2.8 years (range
from 0.1 to 13 years). VUR were found in 217 (36.2%) children, out of them 152 (70%) were females. VUR is
more common in children younger than 2 years of age 115(53%) and it is more in children presented with acute
Pyelonephritis (APN) 172 (78%). However 66 (83.5%) of children with APN had high grade reflux. 106 (53%)
of children with VUR had abnormal renal ultrasound (U/S) finding as well as 70 (61.4%) of them had renal scar
by DMSA scan.
Conclusion: 36.2% of children with documented UTI referred to Tripoli Children Hospital had VUR. It is more
common in females, younger age and more common in children presented with APN. There is high incidence of
renal scaring among children with high grade reflux.