Table of Contents

HK J Paediatr (New Series)
Vol 12. No. 4, 2007

HK J Paediatr (New Series) 2007;12:260-265

Original Article

Outcome of Primary Vesicoureteric Reflux (VUR): A Cohort Study in Chinese Children

AYF Yip, WKY Chan


Background: Primary vesicoureteric reflux (VUR) is a common in children but data on its natural course are scanty in the Chinese population. Objective: To delineate the characteristics and evaluate the natural course of Chinese children with VUR. Method: Chinese children diagnosed to have VUR in a regional hospital, between 1/1/1996 and 31/12/2000, were recruited. Their characteristics at initial presentation and clinical outcome at 5-year old were studied. Results: Sixty-three Chinese children with primary VUR were recruited. The median age at presentation was 8 months old. Seventy-nine percent of patient presented as urinary tract infection (UTI). A male predominance (65% of patient) was noted and both ureters were equally affected. Among the 103 refluxing renal units, 18.5% were grade I, 23.3% grade II, 33.0% grade III, 14.5% grade IV and 10.7% grade V. Of 42 patients with 65 refluxing units who had repeat micturiting cystourethrogram (MCUG) at 5 years old, 48% had resolved. The rates of resolution were 73% for grades I/II, 31% for grades III/IV, and zero for grade V VUR. For those who had undergone 2,3-dimercaptosuccinic acid (DMSA) scans at presentation, 39% showed different degrees of renal scarring. At last assessment none of our patients had developed hypertension. One patient had stage IV chronic kidney disease and one patient had significant proteinuria. Conclusion: Unlike Caucasians, Chinese children have a lower prevalence of VUR and almost half of our studied patients showed resolution of VUR at 5 years old.

背景:兒童出現原發性膀胱輸尿管反流甚為常見,但在中國人種中其自然病程的資料極其缺乏。目的:總結中國兒童膀胱輸尿管反流的特徵並且評價其自然病程。方法:回顧性分析 1996 年 1 月 1 日到 2000 年 12 月 31 日一家地區性醫院診斷為膀胱輸尿管反流的中國兒童的資料,研究他們最初發病和到 5 歲大時臨床演變特徵。結果:共收集患有原發性膀胱輸尿管反流的中國兒童 63 名,平均發病年齡 8 個月。79% 患兒因尿路感染就診,男性尤其常見(佔 65%),並且雙側輸尿管均被累及。在 103 條膀胱輸尿管反流中,18.5% 是 I 級,23.3% 是 II 級,33.0% 是 III 級,14.5% 是 IV 級,10.7% 是 V 級。共有 65 條膀胱輸尿管反流的 42 個 5 歲大的患兒均復查了排尿時的膀胱尿道造影,其中 48% 已經治癒。I/II 級的膀胱輸尿管反流治癒率是 73%,III/IV 級的膀胱輸尿管反流治癒率是 31%,V 級是零。目前已接受 2,3─二巰基琥珀酸掃描的患兒,39% 顯示有不同程度的腎臟疤痕。最終評價所有患兒沒有發展為高血壓的。一個患兒發展為慢性腎病 IV 期,一個患兒發展為顯著的蛋白尿。總結:與白種人不同,中國兒童膀胱輸尿管反流的發病率較低,而且在我們研究的病例中近一半的膀胱輸尿管反流在 5 歲時已治癒。

Keyword : Chinese; Prognosis; Vesicoureteric reflux



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