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原发性膀胱输尿管反流与肾瘢痕

Primary Vesicoureteral Reflux and Renal Scarring.

机构信息

Department of Pediatrics, Wayne State University School of Medicine, 400 Mack Avenue, Suite 1 East, Detroit, MI 48201, USA.

Pediatric Nephrology, University of South Alabama, 1601 Center Street, Suite 1271, Mobile, AL 36604, USA.

出版信息

Pediatr Clin North Am. 2022 Dec;69(6):1115-1129. doi: 10.1016/j.pcl.2022.07.007. Epub 2022 Oct 29.

Abstract

Vesicoureteral reflux (VUR) is the commonest congenital anomaly of urinary tract in children. It is mostly diagnosed after a urinary tract infection or during evaluation for congenital anomalies of the kidney and urinary tract. High-grade VUR, recurrent pyelonephritis, and delayed initiation of antibiotic treatment are important risk factors for renal scarring. The management of VUR depends on multiple factors and may include surveillance only or antimicrobial prophylaxis; very few patients with VUR need surgical correction. Patients with renal scarring should be monitored for hypertension and those with significant scarring should also be monitored for proteinuria and chronic kidney disease.

摘要

膀胱输尿管反流(VUR)是儿童最常见的先天性尿路异常。它大多在尿路感染后或在先天性肾和尿路异常评估期间被诊断。高级别 VUR、复发性肾盂肾炎和延迟开始抗生素治疗是肾瘢痕形成的重要危险因素。VUR 的治疗取决于多种因素,可能仅包括监测或抗菌预防;只有极少数 VUR 患者需要手术矫正。有肾瘢痕的患者应监测高血压,有明显瘢痕的患者还应监测蛋白尿和慢性肾脏病。

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