Height and weight growth in children with vesicoureteral reflux diagnosed before one year old.

OBJECTIVES

To evaluate the different treatment strategies on height and weight growth in children with vesicoureteral reflux (VUR) diagnosed before age 1 year.

METHODS

Height and weight growth were retrospectively studied in 108 children, with 79 boys and 29 girls, having urinary tract infection and then VUR diagnosed before the age 1 year (5.06 +/- 3.34 months). During follow-up for 14-152 months (44.69 +/- 27.28), 45 patients were recovered spontaneously; 24 were corrected by surgery; and 39 were not completely recovered up to the final assessment at the age of 44.69 +/- 27.28 months. We assessed height as height Z score (HZ); and weight as weight for height index (WHI).

RESULTS

Patients had normal initial HZ and WHI values. In analyzing relative risk of final HZ decrease, complete recovery revealed protective effect (P <.01). There was negative correlation between age of recovery and annual HZ change (r = -0.302, P = .001). Patients received surgical correction had higher percentage of moderate or severe VUR (P <.0001), higher recovery rate (P <.001), and younger age of recovery (P = .008). They had significant higher final HZ (P = .016) than those under regular antibiotic prophylaxis without recovery. Both recovered groups had better annual HZ change than those nonrecovered (P = .02). The antibiotic prophylaxis, nonrecovered group had higher final WHI than their initial WHI (P = .011).

CONCLUSIONS

From our data, considering height growth, we suggest that patients with VUR should start treatment early and consider surgical correction if no complete recovery occurs from prolonged antibiotic prophylaxis.