Correlation of Sacral Ratio and Reflux-Related Renal Injury in Children with Vesicoureteral reflux with and without Nephropathy
Journal of Pediatric Nephrology,
Vol. 2 No. 3 (2014),
19 August 2014
,
Page 116-118
https://doi.org/10.22037/jpn.v2i3.6187
Abstract
Introduction: Vesicoureteral reflux refers to the retrograde flow of the urine from the bladder to the ureter and kidney. The ureteral attachment to the bladder is normally oblique, between the bladder mucosa and detrusor muscle, creating a flap-value mechanism that prevents reflux. Reflux occurs when the submucosal tunnel between the mucosa and detrusor muscle is short or absent. The inflammatory reaction caused by pyelonephritis can result in scarring, which is also termed reflux nephropathy. Since sacral bone anomalies have a direct influence on the final function of the urinary and bowel systems, this study was performed to investigate the relationship between sacral ratio and reflux nephropathy.
Materials and Methods: In this case–control study, the case -control group included 200 children under 9 years old who were referred to Amir-Kabir Hospital clinics with urinary tract infection and according to the VCUG and DMSA results, children with various grades of VUR entered the study. The sacral ratio was measured in the two groups and compared by a radiologist. The data were analyzed using Chi-2 and Mann Whitney Tests and software SPSS 16.
Results: The case group included 48 males and 52 females with a mean age of 3.7 years old who had reflux nephropathy, and the control group included 47 males and 53 females with a mean age of 4.1 years who did not have reflux nephropathy. Sacral ratio abnormality was detected in 64% and 23.7% of the cases and controls respectively, which showed a significant difference (p-value=0.003).
Conclusions: Sacral ratio abnormality was more common in children with vesicoureteral reflux and reflux nephropathy than children with VUR without reflux nephropathy.
Keywords: Vesico-Ureteral Reflux; Sacral agenesis; Child; Diagnostic imaging.How to Cite
References
Yousefichaijan p, Baghcheghi N, Koohestani HR. Renal diseases in children. Payam digar 2th edition, 2012 Arak University of Medical Sciences, p 111-125.
Yousefichaijan p, Cyrus A, FazeliMoslehabadi M, Haji Aghabozorgi M. Relationship between sacral ratio and primary enuresis in 5-9 year-old children. AMUJ 2009;12(3):124-130.
Pena A. Anorectal malformations. Seminars in pediatric surgery 1995;4(1):35-47.
Macedo M, Martins JL, FreitasFilho LG. Sacral ratio and fecal continence in children with anorectal malformation. BJU international 2004;94 (6):893-4.
Demirbag S, Senel E, Cetinkursun S. Sacral ratio and fecal continence in children with anorectal malformation. BJU international 2005;95(6):909-910.
Kajbafzadeh AM, Rasuli N. Correlation between the sacral ratio and the outcome of VUR. BJU international, 2001; 87(1):61-3.
Warne SA, Godley ML, Owens CM, Wilcox DT. The validity of sacral ratios to identify sacral abnormalities. BJU international. 2003; 91(6):540-4.
Ahmadi J, Kajbafzadeh AM, Kalantari M, Hadipoor A, Ashjaei B, et al. Evaluation of sacral ratio as prognostic factor in patients with anorectal malformations. Acta Medical Iranian J 2005; 2(43):143-146.
KhaleghNejadTabari A, Saeeda M. The results of posterior sagittal anorectoplasty in anorectal malformations. Archives of Iranian Medicine 2005; 4(8):272-6.
Kajbafzadeh AM, Nejat F, Abbaslou P. Comparison of Sacral ratio in normal children and children with urinary and/or fecal complains. Iran J Pediatric, Mar 2008;Vol 18 (1):57-61.
Yousefichaijan P, Cyrus A, Dorreh F, AhmadiMohtasham M, Hafez Qoran F , Goldust M. Sacral Index in children Suffering from Different Grades of VUR.PJBS,2013; 16(11):545-7.
Basiratnia M, Sacral ratio: Is it an indicator for the prediction of Vesicoureteral reflux? J Ped. Nephrology 2013O;1(2):44-45.
- Abstract Viewed: 428 times
- PDF Downloaded: 256 times