AYF Yip, WKY Chan

Abstract

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.