ESPN 53rd Annual Meeting

ESPN 2021


 
Prevalence of reflux nephropathy in Iranian children with solitary kidney: results of a multi-center study
MARYAM ESTEGHAMATI 1 HADI SORKHI 2 HAMID MOHAMMADJAFARI 3 ALI DRAKHSHAN 4 SIMIN SADEGHI-BOJD 5 HOSSEIN EMAD MOMTAZ 6 MASOUMEH MOHKAM 7 BARANAK SAFAEIAN 8 NAKYSA HOOMAN 9 AFSHIN SAFAEIASL 10 MOHSEN AKHAVAN SEPAHI 11 KHADIJEH GHASEMI 12 ZAHRA BAZARGANI 13 ELHAM EMAMI 14

1- DEPARTMENT OF PEDIATRIC NEPHROLOGY, CLINICAL RESEARCH DEVELOPMENT CENTER OF CHILDRENS HOSPITAL, HORMOZGAN UNIVERSITY OF MEDICAL SCIENCES, BANDAR ABBAS, IRAN
2- NON-COMMUNICABLE PEDIATRIC DISEASES RESEARCH CENTER, HEALTH RESEARCH INSTITUTE, BABOL UNIVERSITY OF MEDICAL SCIENCES, BABOL, IRAN
3- DEPARTMENT OF PEDIATRIC NEPHROLOGY, MAZANDARAN UNIVERSITY OF MEDICAL SCIENCES, SARI, IRAN
4- SHIRAZ NEPHRO-UROLOGY RESEARCH CENTER, SHIRAZ UNIVERSITY OF MEDICAL SCIENCES, SHIRAZ, IRAN
5- GENETICS OF NON-COMMUNICABLE DISEASE RESEARCH CENTER, ZAHEDAN UNIVERSITY OF MEDICAL SCIENCES, ZAHEDAN IRAN
6- DIVISION OF PEDIATRIC NEPHROLOGY, BESAT HOSPITAL, SCHOOL OF MEDICINE, HAMADAN UNIVERSITY OF MEDICAL SCIENCES, HAMADAN, IRAN
7- PEDIATRIC NEPHROLOGY RESEARCH CENTER, RESEARCH INSTITUTE FOR CHILDREN’S HEALTH, SHAHID BEHESHTI UNIVERSITY OF MEDICAL SCIENCES, TEHRAN, IRAN
8- TALEGHANI PEDIATRIC HOSPITAL, GOLESTAN UNIVERSITY OF MEDICAL SCIENCES, GORGAN, IRAN
9- CLINICAL RESEARCH DEVELOPMENT CENTER, IRAN UNIVERSITY OF MEDICAL SCIENCES, TEHRAN, IRAN
10- DEPARTMENT OF PEDIATRICS, GUILAN UNIVERSITY OF MEDICAL SCIENCES, GUILAN, IRAN
11- DEPARTMENT OF PEDIATRICS, SCHOOL OF MEDICINE, QOM UNIVERSITY OF MEDICAL SCIENCES, QOM, IRAN
12- DEPARTMENT OF PEDIATRIC NEPHROLOGY, BUSHEHR UNIVERSITY OF MEDICAL SCIENCES, BUSHEHR, IRAN
13- DEPARTMENT OF PEDIATRICS, SCHOOL OF MEDICINE, FASA UNIVERSITY OF MEDICAL SCIENCES, FASA, IRAN
14- DEPARTMENT OF PEDIATRICS, HAJAR SHAHERKORD UNIVERSITY OF MEDICAL SCIENCES, SHAHREKORD, IRAN
 
Introduction:

 Given the importance of the function of the remnant kidney in children with unilateral renal agenesis and the significance of timely diagnosis and treatment of reflux nephropathy to prevent further damage to the remaining kidney, we aimed to determine the prevalence of reflux nephropathy in this subgroup of pediatric patients. 

Material and methods:

 In general, 274 children referred to pediatric nephrologists in different parts of Iran were evaluated, from which 199 had solitary kidney and were included in this cross-sectional study. The reason for referral included urinary tract infection (UTI), abnormal renal ultrasonography, being symptomatic, and incidental screening. Demographic characteristics consisting of age and gender were recorded. History of UTI and presence of vesicoureteral reflux (VUR) were evaluated. 

Results:

 From the 274 children evaluated in this study with the mean age (SD) of 4.71 (4.24) years, 199 (72.6%) had solitary kidney. Among these 118 (59.3%) were male and 81 (60.7%) were female, 21.1% had a history of UTI, and VUR was present in 23.1%. The most common cause of referral was abnormal renal ultrasonography (40.2%), followed by incidental screening (21.1%), being symptomatic (14.1%), and UTI (5.5%). In 116 children (58.3%), the right kidneys and in 83 (41.7%) the left kidneys were absent. Besides, 14.6% of the participants had consanguineous parents and 3% had a family history of solitary kidney. Upon DMSA scan, the single kidney was scarred in 13.1%. In addition, proteinuria and hematuria were observed in 6.5% and 1.5% of children, respectively.

Conclusions:

 The prevalence of reflux nephropathy was 23.1% in children with solitary kidney with a slight female predominance. Given the relatively high prevalence of reflux nephropathy in these children, screening for VUR in the remnant kidney appears to be essential in this population.