Prevalencia de insuficiencia renal crónica en pacientes pediátricos con relujo vésico-ureteral de la Fundación Cardioinfantil, Bogotá
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Abstract
Background
The vesicoureteral reflux in the infantile population is a cause of frequent consultation as much in the services of pediatrics, like of pediatric nephrology, urology and pediatric surgery, with a prevalence of 1% in healthy children.
Objective
We determined the prevalence of chronic kidney failure in children with vesicoureteral reflux and other variables, in an environment where there are no recent data, management has changed and mortality remains very high.
Methods
Cross sectional analytic study in children with vesicoureteral reflux confirmed by cystography, that visited Pediatric Nephrology for a period of 6 years. Descriptive analysis of variables, estimates of prevalence, bivariate and multivariate analysis of clinical variables of interest.
Results
Data were collected from 99 medical history, with a mean age of 2.94±2.34years, 52.53% female sex, that indicate severe vesicoureteral reflux 81.63%, 67.7% renal scarring, hypertension 28%, proteinuria 31.3%, 47.5% bilateral involvement. The prevalence of chronic renal failure was 27.3 cases per 100% with vesicoureteral reflux (95% CI 18.34 -36.20). After bivariate and multivariate analysis, only hypertension showed statistical significance [bivariate: ORP=12.4 (95% CI 4.37-35.16); multivariate: ORP=15.55 (95% CI 4.48-54.03)].
Discussion
Our prevalence is within the ranks of world literature, predominantly patients with severe vesicoureteral reflux was detected if only to hypertension as a factor associated with prospective multicenter studies are required.
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References
2. De La Peña E. Tratamiento del reflujo vésicoureteral primario en la infancia: comparación de dos revisiones sistemáticas. Actas Urol Esp. 2005;29:138-62.
3. Hayn M, Smaldone M, Ost M, Docimo S. Minimally invasive treatment of vesicoureteral reflux. Urol Clin North Am. 2008;35:477-88.
4. Lagomarsino E. Chronic renal failure in pediatrics 1996. Chilean survey. Pediatr Nephrol. 1999;13:288-91.
5. Gastelbondo R. Estado actual de la insuficiencia renal crónica en pediatría. Memorias, 10º Congreso Colombiano de Nefrología e Hipertensión, Medellín, octubre de 1997. p. 9.
6. López J, Vanegas J, Piedrahita V. Características clínicas del reflujo vesicoureteral en niños atendidos en el Hospital San Vicente de Paúl de Medellín, 1960-2004. Iatreia. 2006;19:141-54.
7. Piedrahita VM, Prada MC, Vanegas JJ, Vélez C, Serna LM, Serrano AK, et al. Causas de enfermedad renal crónica en niños atendidos en el Servicio de Nefrología Pediátrica del Hospital Universitario San Vicente de Paúl, de Medellín,Colombia, entre 1960 y 2010. Iatreia. 2011;24:347-52.
8. Subias JE, Rodríguez GF. Tratamiento médicoconservador versus intervencionista del reflujo vesicoureteral primario en el niño. Arch Esp Urol. 2008;61:229-35.
9. Appiani C, Taioli E, Marra G, Edefonti A, Ardissino FG, Daccò V. Epidemiology of chronic renal failure in children: Data from the ItalKid project. Pediatrics. 2003;111:382-7.
10. Muutinen M, Uhari M, Murphy M, Hey K. Clinical guidelines and hospital discharges of children with acute urinary tract infections. Pediatr Nephrol. 1999;13:45-49.
11. Stefanidis CJ. Reflux nephropathy in children. Nephrology Dialisys Transplantation. 2001;16:117-9.
12. Ardissino G. Avolio L, Dacco V, Testa S, Marra G, Viganò S, et al. Long-term outcome of vesicoureteral reflux associated chronic renal failure in children. Data from the Italkid project. J Urol. 2004;172:305-10.
13. Gastelbondo R, Mesa MP. Etiología y estado actual de la insuficiencia renal crónica en pediatría. Rev Colomb Pediatr. 2002;35:56-62.
14. Parra I, Gastelbondo R. Insuficiencia renal crónica en niños. En: Restrepo C, Castaño I, Restrepo J, editores. Enfoques en nefrología pediátrica. Asociación Colombiana de Nefrología Pediátrica; 2010. p.193-208.
15. Marra G, Oppezzo C, Ardissino G, Dacco V, Testa S, Avolio L, et al. Severe vesicoureteral reflux and chronic renal failure: A condition peculiar to male gender. Data from the ItalKid Project. J Pediatr. 2004;144:677-81.
16. Warady BA, Chadha V. Chronic kidney disease in children: The global perspective. Pediatr Nephrol. 2007;22:1999-2009.
17. Lane W. Vesicoureteral reflux in childhood. Canadian Fam Phys. 1992;38:2155-62.
18. Bogaert GA, Slabbaert K. Vesicoureteral reflux. Eur Urol. 2012;11:16-24.
19. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114:555-76.
20. Universidad Católica de Chile. Razón de prevalencia vs. odds radio de prevalencia en estudios transversales. 2007 (internet). Fecha de consulta: 14 de junio de 2011. Disponible en: escuela.med.puc.cl/recursos/recepidem/epiDesc9.htm.
21. Belman B. Vesicoureteral reflux. Pediatr Clin North Am. 1997;44:1171-90.
22. Sargent MA. What is the normal prevalence of vesicoureteral reflux? Pediatr Radiol. 2000;30:587-93.
23. Asociación Española de Nefrología Pediátrica. Guía de práctica clínica: Manejo del paciente con reflujo vesicoureteral primario o esencial. 2008. Fecha de consulta: 14 de junio de 2011. Disponible en: http://www.guiasalud.es/GPC/GPC_441_Reflujo_VU.pdf.
24. Elder JS, Peters CA, Arant BS Jr, Ewalt DH, Hawtrey CE, Hurwitz RS, et al. Pediatric Vesicoureteral Reflux Guidelines Panel summary report on the management of primary vesicoureteral reflux in children. J Urol. 1997;157:1846-51.
25. Lim R. Vesicoureteral reflux and urinary tract infection: Evolving practices and current controversies in pediatric imaging. AJR. 2009;192:1197-208.
26. Bailey RR. The relationship of vesico-ureteric reflux to urinary tract infection and chronic pyelonephritis-reflux nephropathy. Clin Nephrol. 1973;1:132-41.
27. Smellie J, Edwards D, Hunter N, Normand IC, Prescod N. Vesico-ureteric reflux and renal scarring. Kidney Int. 1975;4:S65-72.
28. Caione P, Villa M. Predictive risk factors forchronic renal failure in primary high grade vesico-ureteric reflux. J Urol. 2005;174:1447.