Insignificant impact of VUR on the progression of CKD in children with CAKUT

Pediatr Nephrol. 2016 Jan;31(1):105-12. doi: 10.1007/s00467-015-3196-1. Epub 2015 Sep 24.

Abstract

Background: Vesicoureteral reflux (VUR) is associated with an increased risk of kidney disorders. It is unclear whether VUR is associated with progression from chronic kidney disease (CKD) to end-stage kidney disease (ESKD) in children with congenital anomalies of the kidney and urinary tract (CAKUT).

Methods: We conducted a 3-year follow-up survey of a cohort of 447 children with CKD (stage 3-5). Rates of and risk factors for progression to ESKD were determined using the Kaplan-Meier method and Cox regression respectively.

Results: Congenital anomaly of the kidney and urinary tract was the primary etiology in 278 out of 447 children; 118 (42.4 %) had a history of VUR at the start of the cohort study. There were significantly more boys than girls with VUR, whereas the proportions were similar in children without VUR. The types of urinary anomalies/complications of the two groups were significantly different. Three-year renal survival rates of the groups were not significantly different, irrespective of CKD stage. Age < 2 years and age after puberty, stage 4 or 5 CKD, and heavy proteinuria, but not history of VUR, were significantly associated with progression to ESKD.

Conclusions: History of VUR at the start of follow-up was not associated with the progression of stage 3-5 CKD in children with CAKUT.

Keywords: Chronic kidney disease; Cohort study; Congenital anomalies of the kidney and urinary tract; End-stage kidney disease; Vesicoureteral reflux.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Child
  • Child, Preschool
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Health Care Surveys
  • Humans
  • Infant
  • Japan / epidemiology
  • Kaplan-Meier Estimate
  • Kidney Failure, Chronic / diagnosis
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / mortality
  • Male
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Puberty
  • Renal Insufficiency, Chronic / diagnosis
  • Renal Insufficiency, Chronic / epidemiology*
  • Renal Insufficiency, Chronic / mortality
  • Risk Assessment
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • Urogenital Abnormalities / diagnosis
  • Urogenital Abnormalities / epidemiology*
  • Urogenital Abnormalities / mortality
  • Vesico-Ureteral Reflux / diagnosis
  • Vesico-Ureteral Reflux / epidemiology*
  • Vesico-Ureteral Reflux / mortality

Supplementary concepts

  • Cakut