Height and weight growth in children with vesicoureteral reflux diagnosed before one year old.

摘要

OBJECTIVES: To evaluate the different treatment strategies on height and weight growth in children with vesicoureteral reflux (VUR) diagnosed before age 1 year. METHODS: Height and weight growth were retrospectively studied in 108 children, with 79 boys and 29 girls, having urinary tract infection and then VUR diagnosed before the age 1 year (5.06 +/- 3.34 months). During follow-up for 14-152 months (44.69 +/- 27.28), 45 patients were recovered spontaneously; 24 were corrected by surgery; and 39 were not completely recovered up to the final assessment at the age of 44.69 +/- 27.28 months. We assessed height as height Z score (HZ); and weight as weight for height index (WHI). RESULTS: Patients had normal initial HZ and WHI values. In analyzing relative risk of final HZ decrease, complete recovery revealed protective effect (P <.01). There was negative correlation between age of recovery and annual HZ change (r = -0.302, P = .001). Patients received surgical correction had higher percentage of moderate or severe VUR (P <.0001), higher recovery rate (P <.001), and younger age of recovery (P = .008). They had significant higher final HZ (P = .016) than those under regular antibiotic prophylaxis without recovery. Both recovered groups had better annual HZ change than those nonrecovered (P = .02). The antibiotic prophylaxis, nonrecovered group had higher final WHI than their initial WHI (P = .011). CONCLUSIONS: From our data, considering height growth, we suggest that patients with VUR should start treatment early and consider surgical correction if no complete recovery occurs from prolonged antibiotic prophylaxis.