Risk Factors for High-Grade Vesicoureteral Reflux in Children Two Years or Younger with Febrile Urinary Tract Infections febrile urinary tract infection
DOI:
https://doi.org/10.61882/ijkd.20.4.9514Keywords:
Pediatrics, Urinary tract infection, Vesicoureteral reflux, Risk factorsAbstract
Introduction. High-grade vesicoureteral reflux (VUR) in infants with febrile urinary tract infections is linked to a heightened risk of renal scarring. Identifying risk factors for high-grade vesicoureteral reflux could enable more selective use of voiding cystourethrography, thereby reducing unnecessary invasive procedures. This study aimed to determine the independent risk factors of high-grade vesicoureteral reflux in children ≤ two years with febrile urinary tract infections.
Methods. According to the defined sample size, a total of 223 children aged two years or younger were referred to the nephrology clinic of Dr.Sheikh children’s hospital affiliated to Mashhad University of Medical Sciences from March 2006 to August 2023, meeting the inclusion criteria. Participants who underwent both kidney ultrasound and voiding cystourethrography (VCUG) were included in the analysis. Univariable and multivariable logistic regression tests were utilized to identify independent risk factors of high-grade VUR.
Results. Of 223 children included in the study, 180 were girls (80.7%). The median age at the presentation was 8.5 months. High-grade vesicoureteral reflux was identified in 23.8%. The univariable analysis revealed that male sex, abnormal renal ultrasound, hydronephrosis, prenatal hydronephrosis, and infections with non- E.coli as potential risk factors. In the multivariable analysis, male sex (OR = 4.41, P < .001), abnormal renal ultrasound (OR = 3.35, P < .001), hydronephrosis (OR = 5.69, P < .001), and prenatal hydronephrosis (OR = 6.31, P = .004) were confirmed independent risk factors .
Conclusion. Male sex, abnormal kidney ultrasound, hydronephrosis, and prenatal hydronephrosis are independent risk factors of high-grade vesicoureteral reflux in children aged ≤2 years with febrile urinary tract infections.
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