CHILDREN WITH VESICOURETERIC REFLUX IN HOSPITAL UNIVERSITI SAINS MALAYSIA: A 12 YEARS REVIEW
| dc.contributor.author | ROSMAWATI, MAT ALI | |
| dc.date.accessioned | 2017-10-30T07:25:42Z | |
| dc.date.available | 2017-10-30T07:25:42Z | |
| dc.date.issued | 2012-06 | |
| dc.description.abstract | Introduction Vesicoureteric reflux (VUR) is the retrograde passage of urine from the bladder into the upper urinary tract. Thirty percent of children with VUR complicated with hypertension, growth failure and chronic kidney disease (CKD). There is no study regarding prevalence, demographic profile, complication, outcome and associated risks factors with VUR been done or published locally at present. Objectives To study demographic characteristics in children with VUR, to determine the survival analysis of children with VUR in relation to development of renal failure, to identify the predictive factor for development of renal failure and associated factor with high grade VUR. Methodology The protocol for the study was approved by the USM Research Ethics Committee (Human) in April 2009. This is a retrospective study of all children diagnosed with VUR treated from paediatric wards and clinics. Children whose medical records were not able to be traced and patient who has underlying chronic disease such as SLE, Nephrotic Syndrome and children on chemotherapy medications were excluded from the study. Informed consent was obtained from the subjects after full explanation of the study procedure. Results Fourty-five children had VUR. The mean age of presentation was 1.3(0.66) years old. Majority of them were boys (30, 66.7%). Twenty-two children (48.9%) had bilateral VUR. Thirty-one children (68.9%) had high grade VUR. VUR were complicated with recurrence UTI (24, 53.3%) and renal failure (14, 31.1%). The median survival time for the children in the high grade VUR group to develop renal failure was eight years. Presence of bilateral VUR was found to be significantly associated with renal failure after adjusting for gender, presence of UTI, income and education [OR (95% CI): p value: 5.7 (1.22, 26.33): p = 0.027]. Presence of recurrence UTI (p = 0.020) and age presentation of VUR less than one year old (p = 0.033) were found to be significantly associated with high grade VUR after adjusting for gender, income and education level. There was a significant association between children with high grade VUR and degree of renal failure, where the p value was 0.034. Conclusion Majority of our patient with vesicoureteric reflux in Hospital Universiti Sains Malaysia were of high grade reflux and potentially lead to renal failure. In our study, predictive factor for renal failure was bilateral VUR. However recurrent UTI and age presentation less than 1 year were predictive factors for high grade VUR. Early identification of risk factor and predictive factor for severe VUR is the first step before proceeding to appropriate diagnostic and therapeutic approach. We believe that this finding will help us to further improve our management but future prospective studies need to be done. | en_US |
| dc.identifier.uri | http://hdl.handle.net/123456789/5169 | |
| dc.language.iso | en | en_US |
| dc.publisher | Pusat Pengajian Sains Perubatan Universiti Sains Malaysia | en_US |
| dc.subject | Paediatrics | en_US |
| dc.title | CHILDREN WITH VESICOURETERIC REFLUX IN HOSPITAL UNIVERSITI SAINS MALAYSIA: A 12 YEARS REVIEW | en_US |
| dc.type | Thesis | en_US |
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