Ewha Med J.  2021 Apr;44(2):46-49. 10.12771/emj.2021.44.2.46.

Unusual Case of Vesicoureteral Reflux and Chronic Kidney Disease in a 10-Year-old Boy with Asymptomatic Bacteriuria

Affiliations
  • 1Department of Pediatrics, Ewha Womans University School of Medicine, Seoul, Korea

Abstract

Primary vesicoureteral reflux is a common genetically determined condition that is associated with varying degrees of renal scarring and represents one of the main causes of chronic kidney disease in children. Usually vesicoureteral reflux is common in urinary tract infection patient under 5 years of age. However, we report a rare case of high-grade vesicoureteral reflux and chronic kidney disease in a 10-year-old boy who was referred to the pediatric department for incidentally detected asymptomatic bacteriuria. Our case demonstrated that high grade vesicoureteral reflux patient with reduced renal function, bladder and bowel dysfunction at presentation is more likely to progress to chronic kidney disease.

Keyword

Vesico-ureteral reflux; Nephropathy; Renal insufficiency; chronic; Bacteriuria

Figure

  • Fig. 1 Abdominal ultrasonographic findings showed (A) right hydroureter of patient, (B) severe hydronephrosis with parenchymal scarring of right kidney, and (C) severe hydronephrosis with parenchymal scarring of left kidney.

  • Fig. 2 Technetium-99m-labeled dimercaptosuccinic acid (99mTC-DMSA) scan. (A) Initial 99mTC-DMSA scan showed multiple cortical defects in both kidneys. The differential kidney function was 25% for right (RT) and 75% for the left (LT) kidney. (B) After 6 months, 99mTC-DMSA scan showed small sized right kidney with decreased uptake and multiple cortical defects in both kidneys. The differential kidney function was 21% for right and 79% for the left kidney.

  • Fig. 3 Voiding cystourethrographic findings. (A) Grade V vesicoureteral reflux on both kidneys and distended bladder in bladder storage phase. (B) Grade V vesicoureteral reflux on both kidneys in bladder voiding phase.


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