Prevalence and Clinical Features of Vesicoureteral Reflux in Children With Recurrent Urinary Tract Infections: A Cross-Sectional Study.

BACKGROUND AND AIMS: Vesicoureteral reflux (VUR) is one of the most common congenital anomalies in children with urinary tract infections (UTIs), potentially leading to serious complications, including renal scarring and permanent kidney damage. This study aimed to assess the prevalence, laterality, and severity of VUR and its associations with demographic, clinical, and functional factors in children with recurrent UTIs.

METHODS

This cross-sectional study examined 109 children aged 2 months to 5 years with recurrent UTIs who were referred to a tertiary center of nephrology clinic. Data collected included age at diagnosis, renal scarring, constipation, voiding dysfunction, gender, VUR grade, and laterality.

RESULTS

Of the 109 children studied, 51.38% had VUR (unilateral or bilateral). The majority of patients were female (78.9%). Unilateral reflux (29.35%) was more frequent than bilateral reflux (22.01%). Among those with VUR, 58.9% had mild to moderate reflux (grades 1-3), while 41.07% had severe reflux (grades 4-5). Renal parenchymal scarring was present in 30.2% of cases, more commonly affecting the right kidney (18.3%) than the left (4.6%). Voiding dysfunction was highly prevalent (66.1%) and was significantly associated with VUR. Most patients (85.3%) received antibiotic prophylaxis, although its association with renal scarring was not statistically significant.

CONCLUSION

This study identified a higher prevalence of VUR among children with recurrent UTIs than previously reported, with unilateral and mild-to-moderate reflux being predominant. The findings highlight the interplay between female gender, voiding dysfunction, and VUR in recurrent pediatric UTIs. Early detection and targeted management, including addressing bladder-bowel dysfunction and judicious use of antibiotic prophylaxis, are essential to prevent recurrent infections and reduce the risk of renal damage.