Shi Shengkun,Yang Yi.Research advances on risk factors and preventions of renal scar associated with primary vesicoureteral reflux[J].Journal of Clinical Pediatric Surgery,,22():937-943.[doi:10.3760/cma.j.cn101785-202305011-007]
Research advances on risk factors and preventions of renal scar associated with primary vesicoureteral reflux
- Abstract:
- As a common urinary system anomaly in children,vesicoureteral reflux (VUR) has attracted growing attention from scholars at both home and abroad.A particular focus is irreversible renal scar of VUR.Numerous studies have examined its risk factors and preventive measures.After the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial in 2007,the results of relevant trials and statistical studies have been published successively.New concepts have been proposed for evaluating the therapeutic effectiveness of oral prophylactic antibiotics after primary urinary tract infection (UTI) and the risk factors for renal scarring in VUR children.This review summarized the risk factors of renal scarring due to primary VUR and the latest researches of oral prophylactic antibiotic therapy.
References:
[1] Kara E,Sakaci T,Ahbap E,et al.Posttransplant urinary tract infection rates and graft outcome in kidney transplantation for end-stage renal disease due to reflux nephropathy versus chronic glomerulonephritis[J].Transplant Proc,2016,48(6):2065-2071.DOI:10.1016/j.transproceed.2016.05.009.
[2] Carpenter MA,Hoberman A,Mattoo TK,et al.The RIVUR trial:profile and baseline clinical associations of children with vesicoureteral reflux[J].Pediatrics,2013,132(1):e34-e45.DOI:10.1542/peds.2012-2301.
[3] Mattoo TK.Vesicoureteral reflux and reflux nephropathy[J].Adv Chronic Kidney Dis,2011,18(5):348-354.DOI:10.1053/j.ackd.2011.07.006.
[4] Hodson CJ,Maling TM,McManamon PJ,et al.The pathogenesis of reflux nephropathy(chronic atrophic pyelonephritis)[J].Br J Radiol,1975,48(Suppl 13):1-26.
[5] Hewitt I,Montini G.Vesicoureteral reflux is it important to find?[J].Pediatr Nephrol,2021,36(4):1011-1017.DOI:10.1007/s00467-020-04573-9.
[6] García Nieto VM,Monge Zamorano M,Antón Hernández L,et al.Reflux nephropathy and scarring nephropathy:so close and yet so different[J].An Pediatr (Engl Ed),2022,97(1):40-47.DOI:10.1016/j.anpede.2021.08.008.
[7] Johnston DL,Qureshi AH,Irvine RW,et al.Contemporary management of vesicoureteral reflux[J].Curr Treat Options Pediatr,2016,2(2):82-93.DOI:10.1007/s40746-016-0045-9.
[8] Shaikh N,Ewing AL,Bhatnagar S,et al.Risk of renal scarring in children with a first urinary tract infection:a systematic review[J].Pediatrics,2010,126(6):1084-1091.DOI:10.1542/peds.2010-0685.
[9] Murugapoopathy V,McCusker C,Gupta IR.The pathogenesis and management of renal scarring in children with vesicoureteric reflux and pyelonephritis[J].Pediatr Nephrol,2020,35(3):349-357.DOI:10.1007/s00467-018-4187-9.
[10] Mattoo TK,Chesney RW,Greenfield SP,et al.Renal scarring in the randomized intervention for children with vesicoureteral reflux (RIVUR) trial[J].Clin J Am Soc Nephrol,2016,11(1):54-61.DOI:10.2215/CJN.05210515.
[11] Peters CA,Skoog SJ,Arant BS Jr,et al.Summary of the AUA guideline on management of primary vesicoureteral reflux in children[J].J Urol,2010,184(3):1134-1144.DOI:10.1016/j.juro.2010.05.065.
[12] Pecile P,Miorin E,Romanello C,et al.Age-related renal parenchymal lesions in children with first febrile urinary tract infections[J].Pediatrics,2009,124(1):23-29.DOI:10.1542/peds.2008-1192.
[13] Mihi B,Good M.Impact of Toll-like receptor 4 signaling in necrotizing enterocolitis:the state of the science[J].Clin Perinatol,2019,46(1):145-157.DOI:10.1016/j.clp.2018.09.007.
[14] Ragnarsdóttir B,Samuelsson M,Gustafsson MCU,et al.Reduced toll-like receptor 4 expression in children with asymptomatic bacteriuria[J].J Infect Dis,2007,196(3):475-484.DOI:10.086/518893.
[15] Kollmann TR,Kampmann B,Mazmanian SK,et al.Protecting the newborn and young infant from infectious diseases:lessons from immune ontogeny[J].Immunity,2017,46(3):350-363.DOI:10.1016/j.immuni.2017.03.009.
[16] Zulic E,Hadzic D,Cosickic A,et al.Frequency of urinary tract infection when diagnosing vesico uretheral reflux in children in Tuzla Canton[J].Mater Sociomed,2023,35(1):4-7.DOI:10.5455/msm.2023.35.4-7.
[17] Albracht CD,Hreha TN,Hunstad DA.Sex effects in pyelonephritis[J].Pediatr Nephrol,2021,36(3):507-515.DOI:10.1007/s00467-020-04492-9.
[18] Hreha TN,Collins CA,Daugherty AL,et al.Androgen-Influenced polarization of activin A-producing macrophages accompanies post-pyelonephritic renal scarring[J].Front Immunol,2020,11:1641.DOI:10.3389/fimmu.2020.01641.
[19] Pepe G,Locati M,Della Torre S,et al.The estrogen-macrophage interplay in the homeostasis of the female reproductive tract[J].Hum Reprod Update,2018,24(6):652-672.DOI:10.1093/humupd/dmy026.
[20] Straub RH.The complex role of estrogens in inflammation[J].Endocr Rev,2007,28(5):521-574.DOI:10.1210/er.2007-0001.
[21] Shaikh N,Haralam MA,Kurs-Lasky M,et al.Association of renal scarring with number of febrile urinary tract infections in children[J].JAMA Pediatr,2019,173(10):949-952.DOI:10.1001/jamapediatrics.2019.2504.
[22] O’Brien VP,Hannan TJ,Yu L,et al.A mucosal imprint left by prior Escherichia coli bladder infection sensitizes to recurrent disease[J].Nat Microbiol,2016,2:16196.DOI:10.1038/nmicrobiol.2016.196.
[23] Sürmeli D?ven S,Erdo?an S.Vitamin D deficiency as a risk factor for renal scarring in recurrent urinary tract infections[J].Pediatr Int,2021,63(3):295-299.DOI:10.1111/ped.14397.
[24] Shaikh N,Mattoo TK,Keren R,et al.Early antibiotic treatment for pediatric febrile urinary tract infection and renal scarring[J].JAMA Pediatr,2016,170(9):848-854.DOI:10.1001/jamapediatrics.2016.1181.
[25] Kosmeri C,Kalaitzidis R,Siomou E.An update on renal scarring after urinary tract infection in children:what are the risk factors?[J].J Pediatr Urol,2019,15(6):598-603.DOI:10.1016/j.jpurol.2019.09.010.
[26] Risdon RA.Reflux nephropathy[J].Diagn Histopathol,1981,4(1):61-70.
[27] Muniz G,Kar E,Gumus S,et al.Constipation on abdominal radiograph as potential risk factor for recurrent urinary tract infection development[J].Pediatr Nephrol,2021,36(9):2769-2775.DOI:10.1007/s00467-021-04973-5.
[28] Meena J,Mathew G,Hari P,et al.Prevalence of bladder and bowel dysfunction in toilet-trained children with urinary tract infection and/or primary vesicoureteral reflux:a systematic review and meta-analysis[J].Front Pediatr,2020,8:84.DOI:10.3389/fped.2020.00084.
[29] Schneider KO,Lindemeyer K,Kammer B.Intrarenal reflux,an overlooked entity-retrospective analysis of 1,166 voiding cysturethrographies in children[J].Pediatr Radiol,2019,49(5):617-625.DOI:10.1007/s00247-018-04330-z.
[30] Simi?i? Majce A,Arapovi? A, ?apkun V,et al.The spectrum of parenchymal changes in kidneys affected by intrarenal reflux,diagnosed by contrast-enhanced voiding urosonography and DMSA scan[J].Front Pediatr,2022,10:886112.DOI:10.3389/fped.2022.886112.
[31] Arapovi? A,Punda A,Brdar D,et al.Types of parenchymal changes diagnosed on DMSA scans of kidneys affected by different grades of vesicoureteral reflux[J].Med Sci Monit,2021,27:e929617.DOI:10.12659/MSM.929617.
[32] Everaert K,Van Laecke E,Dekuyper P,et al.Impact of urinary tract infection and detrusor pressure on renal tubular function in patients with vesicoureteral reflux[J].Eur Urol,2001,39(3):337-342.DOI:10.1159/000052464.
[33] Goren MR,Ceyhan E,Ozer C,et al.The impact of reflux pressure on renal scarring in children with sterile vesicoureteral reflux[J].J Pediatr Urol,2023,19(1):130.e1-130.e5.DOI:10.1016/j.jpurol.2022.09.016.
[34] Watson AR.Management of urinary tract infection in children[J].BMJ,2007,335(7616):356-357.DOI:10.1136/bmj.39309.423542.80.
[35] Tullus K.What do the latest guidelines tell us about UTIs in children under 2 years of age[J].Pediatr Nephrol,2012,27(4):509-511.DOI:10.1007/s00467-011-2077-5.
[36] Subcommittee on Urinary Tract Infection,Steering Committee on Quality Improvement and Management,Roberts KB.Urinary tract infection:clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months[J].Pediatrics,2011,128(3):595-610.DOI:10.1542/peds.2011-1330.
[37] Brandstr?m P,Nevéus T,Sixt R,et al.The Swedish reflux trial in children:IV.Renal damage[J].J Urol,2010,184(1):292-297.DOI:10.1016/j.juro.2010.01.060.
[38] Damm T,Mathews R.The RiVUR study outcomes and implications on the management of vesicoureteral reflux[J].Arch Nephrol Ren Stud,2022,2(1):1-5.
[39] Hari P,Bagga A.Antimicrobial prophylaxis for children with vesicoureteral reflux[J].N Engl J Med,2014,370(11):1071-1072.DOI:10.1056/NEJMc1408559.
[40] Mathews R,Mattoo TK.The role of antimicrobial prophylaxis in the management of children with vesicoureteral reflux-the RIVUR study outcomes[J].Adv Chronic Kidney Dis,2015,22(4):325-330.DOI:10.1053/j.ackd.2015.04.002.
[41] Wang HH,Kurtz M,Logvinenko T,et al.Why does prevention of recurrent urinary tract infection not result in less renal scarring? A deeper dive into the RIVUR trial[J].J Urol,2019,202(2):400-405.DOI:10.1097/JU.0000000000000292.
[42] Hoberman A,Greenfield SP,Mattoo TK,et al.Antimicrobial prophylaxis for children with vesicoureteral reflux[J].N Engl J Med,2014,370(25):2367-2376.DOI:10.1056/NEJMoa1401811.
[43] Shaikh N,Rajakumar V,Peterson CG,et al.Cost-utility of antimicrobial prophylaxis for treatment of children with vesicoureteral reflux[J].Front Pediatr,2019,7:530.DOI:10.3389/fped.2019.00530.
[44] Bertsimas D,Li M,Estrada C,et al.Selecting children with vesicoureteral reflux who are most likely to benefit from antibiotic prophylaxis:application of machine learning to RIVUR[J].J Urol,2021,205(4):1170-1179.DOI:10.1097/JU.0000000000001445.
[45] Wang ZT,Wehbi E,Alam Y,et al.A reanalysis of the RIVUR trial using a risk classification system[J].J Urol,2018,199(6):1608-1614.DOI:10.1016/j.juro.2017.11.080.
[46] Mattoo TK,Shaikh N,Nelson CP.Contemporary management of urinary tract infection in children[J].Pediatrics,2021,147(2):e2020012138.DOI:10.1542/peds.2020-012138.
[47] 中华医学会小儿外科学分会泌尿外科学组.儿童原发性膀胱输尿管反流的专家共识[J].临床小儿外科杂志,2019,18(10):811-816.DOI:10.3969/j.issn.1671-6353.2019.10.002.Group of Urology,Branch of Pediatric Surgery,Chinese Medical Association:Expert Consensus on Managing Primary Vesicoureteral Reflux in Children[J].J Clin Ped Sur,2019,18(10):811-816.DOI:10.3969/j.issn.1671-6353.2019.10.002.
[48] Su DQ,Shen Q,Zhai YH,et al.Risk factors for breakthrough urinary tract infection in children with vesicoureteral reflux receiving continuous antibiotic prophylaxis[J].Transl Pediatr,2022,11(1):1-9.DOI:10.21037/tp-21-398.
Memo
收稿日期:2023-5-8。
基金项目:辽宁省教育厅基本科研项目(LJKMZ20221180);辽宁省重点研发计划联合计划项目(2020JH2/10300145)
通讯作者:杨屹,Email:yangy2@sj-hospital.org