THE FOLLOW-UP STUDY OF RENAL FUNCTION IN VESICOURETERAL REFLUX

The Effect of Conservative Treatment and Antireflux Operation

Abstract

The retrospective analyses of renal function were made in 177 patients with primary VUR. Of these patients (121 children and 56 adults), 111 patients had antireflux operations. Renal function was assessed with IVP and renal radioisotope examinations (¹³¹I-Hippuran renogram, ^99mTc-DTPA dynamic study). The results are as follows:
1) ^99mTc-DTPA renogram showed a slight reduction of renal function in 8 of 31 grade IIA reflux kidneys whose IVP indicated normal renal functions. All of these kidneys were treated conservatively or had conservative treatments before antireflux operations. The conservative treatment might have induced only a progress of renal failure in some cases even if they were with low grade refluxes.
2) The kidneys, whose preoperative T 1/2 in ¹³¹I-hippuran renogram were more than 18 minutes, could not recover in their functions. Antireflux operation should be carried out before reflux kidney is damaged irreversibly.
3) Thus, renal radioisotope examinations (¹³¹I-Hippuran renogram, ^99mTc-DTPA dynamic study) are very useful to detect the reflux nephropathy and decide the antireflux operation.