Spontaneous resolution of vesicoureteral reflux (VUR) in Iranian children: A single center experience in 533 cases

Background: experience with vesicoureteral reflux (vur) resolution differs in different centers. objective: the aim of this study was to evaluate the epidemiologic characteristics and outcome of vur among iranian children. patients and methods: in this cohort study, 1278 children with urinary tract infection (uti) who were visited at the pediatric nephrology clinic; tehran, ir iran during 1999 to 2007 were studied. following the diagnosis, patients received prophylactic low- dose oral antibiotic and one to two yearly follow-ups with radionuclide cystography (rnc). patients underwent surgery in case of breakthrough infection or new renal scar formation. results: vesicoureteral reflux was found in 533 patients (42%) with a mean age of 6.3± 3.6 years (range 2 days to 18 years), out of which 436 (82%) were females. during 3.3 ± 2.2 years follow-up, spontaneous resolution was observed in 109 (39%) of 279 patients with follow-up rncs. mean time to spontaneous resolution was 1.5 ± 1 years. frequen- cies of vur grades at initial investigation were 18%, 37%, 26%, 11% and 8% for grades i to v respectively, and 46% had bilateral vur. grades i to v resolved in 63%, 57%, 27%, 22% and 10%, respectively. anti reflux surgery was performed in 27(10%) of patients. two handred fourty nine patients proceeded to follow-up with dimercaptosuccinic acid (dmsa) scan. there were 4 (4%) renal scars in patients with spontaneous resolution and 8 (5%) renal scars in patients without spontaneous resolution of vur (p > 0.05). conclusions: according to the excellent results with medical therapy, it is recommended that vur grades 1 to 4 be managed medically with low-dose antibiotic prophylaxis and close follow-ups.