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A scoring system for predicting downgrading and resolution of high-grade infant vesicoureteral reflux

Artikel i vetenskaplig tidskrift
Författare Sofia Sjöström
Aldina Pivodic
K. Abrahamsson
R. Sixt
E. Stokland
S. Hansson
Publicerad i Acta Paediatrica
Sidor 10
ISSN 0803-5253
Publiceringsår 2020
Publicerad vid Institutionen för neurovetenskap och fysiologi
Institutionen för kliniska vetenskaper
Sidor 10
Språk en
Länkar dx.doi.org/10.1111/apa.15404
Ämnesord high-grade, infants, resolution and downgrading, scoring system, vesicoureteral reflux, urinary-tract-infections, computational model, children, guidelines, trial, risk, Pediatrics
Ämneskategorier Pediatrik

Sammanfattning

Aim Aim of the study was to provide a scoring system for predicting downgrading and resolution of infantile high-grade vesicoureteral reflux (VUR). Methods Eighty-nine infants (65 boys) with high-grade VUR (grade 4-5) diagnosed at median age 2.5 months and followed to 39 months had repeated investigations of VUR grade, renal damage/function and bladder function. Recurrent urinary tract infections (UTIs) were registered. Risk variables collected at 1 year were analysed as independent factors for spontaneous resolution to grades <= 2 and 0, using univariable/multivariable logistic regression. Results A scoring system was built with a total of 14 points from four independent risk factors (sex, breakthrough UTI, type of renal damage and subnormal glomerular filtration rate). Children with persistent VUR (grade 3-5) had higher scores compared with the group with spontaneous resolution (grade 0-2) (mean 7.9 vs. 4.5,P < .0001). A score of >= 8 points indicated a low probability of VUR resolution (<= 14%). The model was considered excellent based on area under the ROC curve (0.82) and showed satisfactory internal validity. Conclusion This model provides a practical tool in the management of infants born with high-grade reflux. High scores at one year of age indicate a high risk of persistent dilated reflux.

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