This study from Italy investigated the association of vesicoureteral reflux (VUR) and renal scarring.
It has been shown that children with a febrile urinary tract infection (UTI) and no VUR may have evidence of renal defects when imaged with scintigraphic studies. Therefore, it has been postulated that VUR is a weak predictor of renal defects.
The group employed isotopic cystography (IC) for diagnosis of VUR in children with febrile UTIs. Dimercaptosuccinic acid renal scintigraphy was performed 6 months after cure of the last UTI. They defined renal defects by the observation of focal defects of radionuclide uptake and/or by a split renal function <43%. The study included 206 children with primary VUR and 77 without VUR. Among the patients with and without VUR, respectively, renal defects were found in 40 and 6% (p=0.0001), focal uptake defects in 33 and 5% (p=0.0001) and split renal function <43% in 26 and 5% (p=0.0001). From this data the group concluded that renal defects in children with febrile UTI are closely associated with VUR. They state that the possibility that a child will have permanent renal defects can reasonably be ruled out on the basis of the absence of VUR by IC.