ArticlePediatric nephrology (Berlin, Germany)2009
Vesicoureteric reflux is not a benign condition.
Article in Pediatric nephrology (Berlin, Germany), 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 66 citations in OpenAlex.
- Genetic susceptibility to renal scar formation after urinary tract infection: a systematic review and meta-analysis of candidate gene polymorphisms.Pediatric nephrology (Berlin, Germany) · 2011Pooled it
- Evidence for and against urinary prophylaxis in vesicoureteral reflux.Pediatric nephrology (Berlin, Germany) · 2010Pooled it
- Conflicting views of physicians and surgeons concerning pediatric urinary tract infection: a comparative review.Pediatric radiology · 2023Review
- Relationship between Vesicoureteral Reflux and Glomerular Filtration Rate in Children.Current medical science · 2020Article
- Urinary tract infections in children.Lancet (London, England) · 2020Review
- Contrast-enhanced voiding urosonography with intravesical administration of ultrasound contrast agent for the diagnosis of pediatric vesicoureteral reflux.Experimental and therapeutic medicine · 2018Article
- Imaging studies and biomarkers to detect clinically meaningful vesicoureteral reflux.Investigative and clinical urology · 2017Review
- Vesicoureteral refux detection in children: a comparison of the midline-to-orifice distance measurement by ultrasound and voiding urosonography.Pediatric nephrology (Berlin, Germany) · 2016Article
- Insignificant impact of VUR on the progression of CKD in children with CAKUT.Pediatric nephrology (Berlin, Germany) · 2016Article
- Comparison of procalcitonin and different guidelines for first febrile urinary tract infection in children by imaging.Pediatric nephrology (Berlin, Germany) · 2014Article
- Relevance of current guidelines in the management of VUR.European journal of pediatrics · 2014Review
- Does prompt treatment of urinary tract infection in preschool children prevent renal scarring: mixed retrospective and prospective audits.Archives of disease in childhood · 2014Article
- Autologous fibroblast transplantation at the vesico-ureteral junction as potential reconstructive cell replacement in an animal model.World journal of urology · 2013Article
- Managing children under 36 months of age with febrile urinary tract infection: a new approach.Pediatric nephrology (Berlin, Germany) · 2012Article
- The impact of vesicoureteral reflux treatment on the incidence of urinary tract infection.Pediatric nephrology (Berlin, Germany) · 2012Review
- Radiographic evaluation of children with febrile urinary tract infection: bottom-up, top-down, or none of the above?Advances in urology · 2012Article
- Outcome and management of isolated severe renal pelvis dilatation detected at postnatal screening.Pediatric nephrology (Berlin, Germany) · 2010Article
- Learning from history or the rationale for considering surgical correction of vesicoureteral reflux.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2010Article
- Vesicoureteral reflux in children with suspected and proven urinary tract infection.Pediatric nephrology (Berlin, Germany) · 2010Article
- Catheter-free methods for vesicoureteric reflux detection: our experience and a critical appraisal of existing data.Pediatric nephrology (Berlin, Germany) · 2010Review
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1 author at 1 institution in 1 country.
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Abstract
Renal parenchymal defects may be congenital, usually associated with dilated vesicoureteric reflux (VUR), or they may appear in previously normal kidneys and be caused by reflux nephropathy due to VUR combined with urinary tract infection (UTI). A piglet model defined that the 70% of children with VUR and vulnerable pyramids would scar rapidly with their first UTI. Because most defects are present at first imaging after a UTI, and from the lack of benefit from apparently reasonable clinical interventions, many now believe that most defects are congenital, their association with VUR being a shared dysplasia rather than causal. Consequently, guidelines now argue for less assiduous management. These conclusions ignore adult human transplant evidence, adult pig studies, and clinical anecdotes, which indicate that scars may develop in infant kidneys quicker than urine culture can confirm the diagnosis, and that reflux nephropathy has no age limit. Its rarity over 4 years suggests that most vulnerable children develop scars before then, despite all medical efforts. I argue that preventing such scarring will require better diagnosis of infant UTI, quicker treatment, reliable imaging of scars and VUR, and subsequent protection until VUR resolves. To make a difference, we need more assiduous management, not less, and cannot afford to consider VUR to be a benign condition.
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