Evaluation of the Clinical Findings of Pediatric Patients With Vesicoureteral Reflux to Assess Disease Severity: Vesicoureteral Reflux and Disease Severity
Background and Aim: This study aims to investigate how to benefit from clinical andlaboratory methods for further selection in the decision-making process to perform acystogram and assess the severity of vesicoureteral reflux (VUR).Methods: We retrospectively reviewed the voiding cystourethrography (VCUG), ultrasound(US), and medical records of pediatric patients with VUR. The exclusion criteria includedhaving neurological lesions, a posterior urethral valve, and a lack of documentation of a renalultrasound or voiding cystourethrography (VCUG). At the time of data entry, we retrieveddemographic findings and laboratory test results, including routine biochemical parameters,complete blood count, and calculated blood sodium/potassium ratioResults: Sixty-three pediatric patients with VUR were enrolled in this study. The mean (SD)age of the patients (female/male=37/26) at the time of diagnosis was 62.0±6.5 months (range1-195 months). Seventeen patients (26.9%) had high-grade VUR, and 46 patients (73.1%)had low-to-moderate-grade VUR. The mean potassium level of the mean serum sodium topotassium (Na/K) ratio was significantly lower in the high-grade VUR group (4.7±0.5 vs.4.3±0.4 mEq/L, P=0.022, 29±3 vs. 32±3, P=0.029, respectively). The proportion of patientswith severe anterior-posterior (AP) diameter dilation was significantly higher in the lowgradeVUR group than in the high-grade VUR group (4 [23.5%] vs. 35 [76.5%], P=0.005).Conclusion: We conclude that the low serum sodium to potassium (Na/K) ratio allows us topredict the VUR grade. The effect of VUR on the renin-angiotensin-aldosterone system canbe demonstrated by prospective controlled studies
