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Renal Parenkimal Skar ve Reflü Nefropatisi

Renal Parenchymal Scarring and Reflux Nephropathy

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 2012
DOI: 
DOI 10.5262/tndt.2012.1001.04

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Vesicoureteral reflux (VUR) is the abnormal flow of urine from the bladder into the upper urinary tract. In the majority of cases, it occurs as a result of a primary maturation abnormality of the vesicoureteral junction. When VUR is associated with bacteriuria, the possibility of pyelonephritis with subsequent renal scars increases, theoretically as a result of bacteria being more readily conveyed to the renal parenchyma. The ultimate evaluation for renal scars is done through a cortical renal scan using technetium-99 labeled dimercaptosuccinic acid. The long term complication of VUR is nephropathy. Reflux nephropathy (RN) is defined as the formation of renal parenchymal scarring and renal function impairment induced by VUR. Hypertension, proteinuria, chronic kidney disease and end stage renal failure are well-recognized sequelae of renal scars. In this review we tried to emphasize the importance of RN which is stil a significant cause of morbidity especially in developing countries.
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Abstract (Original Language): 
Vezikoüreteral reflü (VUR), üreterin mesane içine giriş yerinin yetersizliği sonucu idrarın mesaneden üreterlere ve renal toplayıcı sisteme geriye kaçışını ifade eder. Vezikoüreteral reflü bakterilerin mesaneden üst üriner sisteme taşınmasını sağlayarak piyelonefrite yol açabilir. Piyelonefrit sırasında oluşan yangı bir veya her iki böbrekte renal parenkimal hasar (RPS) olarak adlandırılan kalıcı zedelenmeye neden olabilir. Günümüzde RPS tanısı için kullanılan yöntem statik kortikal renal sintigrafidir, teknesyum-99m-dimerkaptosüksinik asit kullanılarak yapılır. Vezikoüreteral reflünün uzun dönem komplikasyonu nefropatidir. Reflü nefropatisi (RN), VUR’a ikincil olarak gelişen RPS oluşumu ve böbrek fonksiyonlarında bozulmayı ifade eder. Hipertansiyon, proteinüri, kronik böbrek hastalığı ve son dönem böbrek hastalığı RN’nin iyi bilinen uzun dönemdeki komplikasyonlarıdır. Biz bu derlememizde ülkemizde ve gelişmekte olan ülkelerde halen büyük bir morbidite nedeni olan RN’ne dikkatleri çekmek istedik.
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REFERENCES

References: 

1. Mackie GG, Stephens FD: Duplex kidneys: A correlation of renal
dysplasia with position of the ureteral orifis. J Urol 1975; 114:
274-280
2. Kaefer M, Curan M, Treves ST, Bauer S, Hendren WH, Peters
CA, Atala A, Diamond D, Retik A: Sibling vesicoureteral reflux in
multiple gestation births. Pediatrics 2000; 105: 800-804
3. Lines D: 15th century ureteric reflux. Lancet 1982; 2: 1473
4. Polk HC Jr: Notes on Galenic urology. Urol Survey 1965; 15: 2-6
5. Burger RH, Smith C: Hereditary and familial vesicoureteral reflux.
J Urol 1971; 106: 845-851
6. Ransley PG: Vesicoureteral reflux: Continuing surgical dilemma.
Urology 1978; 12: 246-255
7. Jerkins GR, Noe HN: Familial vesicoureteral reflux: A prospective
study. J Urol 1982; 128: 774-778
8. Van den Abbeele AD, Treves ST, Lebowitz RL, Bauer S, Davis RT,
Retik A, Colodny A: Vesicoureteral reflux in asymptomatic siblings
of patients with known reflux: Radionuclide cystography. Pediatrics
1987; 79: 147-153
9. Smellie JM, Edwards D, Hunter N: Vesicoureteral reflux and renal
scarring. Kidney Int 1975; 4: 65-72
10. Blickman JG, Taylor GA, Lebowitz RL: Voiding cystoureterography
as the initial radiologic study in children with urinary tract infection.
Radiology 1985; 156: 659-662
11. Gelfand MJ, Koch BL, Elgazzar AH, Gylys-Morin VM, Gartside
PS, Torgerson CL: Cyclic Cystography: Diagnostic yield in selected
pediatric populations. Radiology 1999; 213: 118-120
12. Zerin JM, Ritchey ML, Chang AC: Incidental vesicoureteral reflux
in neonates with antenatally detected hydronephrosis and other
renal abnormalities. Radiology 1993; 187: 157-160
13. Ring E, Petritsch P, Riccabona M, Haim-Kuttnig M, Vilits P,
Rauchenwald M, Fueger G: Primary vesicoureteral reflux in infants
with a dilated fetal urinary tract. Eur J Pediatr 1993; 152: 523-525
14. Askari A, Belman AB: Vesicoureteral reflux in black girls. J Urol
1982; 127: 747-748
35. Ransley PG, Risdon RA: Reflux and renal scarring. Br J Rad 1978;
14: 1-35
36. Winberg J: Commentary: Progressive renal damage from infection
with or without reflux . J Urol 1992; 148: 1733-1734
37. Obling H, Claesson I, Ebel K, Seppänen U, Smellie JM, Tamminen-
Möbius T, Wikstad I: Renal scars and parenchymal thinning in
children with vesicoureteral reflux: The International Reflux Study
in Children (European branch). J Urol 1992; 148: 1653-1656
38. Skoog SJ, Belman AB, Majd M: A non surgical approach to the
management of primary vesicoureteral reflux. J Urol 1987; 138:
941-946
39. Majd M, Rushton HG, Jantausch B, Wiedermann BL: Relationship
among vesicoureteral reflux, P-fimbriated E. Coli and acute
pyelonephritis in children with febrile urinary tract infection. J
Pediatr 1991; 119: 578-585
40. Soylu A, Demir BK, Türkmen M, Bekem O, Saygi M, Cakmakçi
H, Kavukçu S: Predictors of renal scar in children with urinary
infection and vesicoureteral reflux. Pediatr Nephrol 2008; 23:
2227-2232
41. Bounomo C, Treves ST, Jones B, Summerville D, Bauer S, Retik
A: Silent renal damage in symptom free siblings of children
with vesicoureteral reflux: Assesment with tecnetium Tc-99m
dimercaptosuccinic acid scintigraphy. J Pediartr 1993; 122: 721-723
42. Clarke SE, Smellia JM, Prescod N, Gurney S, West DJ: Tc-99m
DMSA studies in pediatric urinary tract infections. J Nucl Med
1996; 37: 823-828
43. Craig JC, Irwig L, Ford M, Willis NS, Howman-Giles RB, Uren RF,
Rossleigh MA,Grunewald S: Reliability of DMSA for the diagnosis
of renal parenchymal abnormality in children. Eur J Nucl Med
2000; 27: 1610-1616
44. Rosseleigh MA: Renal cortical scintigraphy and diuresis renography
in infants and children. J Nucl Med 2001; 42: 91-95
45. Imperiale A, Olianti C, Sestini S, Materassi M, Seracini D, Ienuso
R, La Cava G: 123I-Hippuran Renal Scintigraphy with evaluation
of single-kidney clearance for predicting renal scarring after acute
urinary tract infection: Comparison with 99mTc-DMSA Scanning.
J Nucl Med 2003; 44: 1755-1760
46. Treves ST, Gelfand M, Willi UV: Vesicoureteric reflux and
radionuclide cystography. In: Treves ST (ed). Pediatric Nuclear
Medicine. New York: Springer-Verlag, 1991: 411-429
47. Sheu JN, Chen MC, Lue KH, Cheng SL, Lee IC, Chen SM, Tsay
GJ: Serum and urine levels of interleukin-6 and interleukin-8 in
children with acute pyelonephritis. Cytokine 2006; 36: 276-282
48. Kassır K, Vargas-Shiraishi O, Zaldivar F, Berman M, Singh J,
Arrieta A: Cytokine profiles of pediatric patients treated with
antibiotics for pyelonephritis: Potential therapeutic impact. Clin
Diagn Lab Immunol 2001; 8: 1060-1063
49. Ninan GK, Jutley RS, Eremin O: Urinary cytokines as markers of
reflux nephropathy. J Urol 1999; 162: 1739-1742
15. Anonymous: Vesicoureteral reflux: All in the genes? Report of
a meeting of physicians at the hospital for sick children (clinical
conferance). Lancet 1996; 348: 725-728
16. Soylu A, Kasap B, Demir K, Türkmen M, Kavukçu S: Predictive
value of clinical and laboratory variables for vesicoureteral reflux in
children. Pediatr Nephrol 2007; 22: 844-848
17. Sheldon CA, Wacksman J: Vesicoureteral reflux. Pediatr Rev 1995;
16: 22-27
18. Report of the International Reflux Study Committee: Medical versus
surgical treatment of primary vesicoureteral reflux. Pediatrics 1981;
67: 392-400
19. Willi UV, Treves ST: Radionuclide voiding cystography. In: Treves
ST (ed). Pediatric Nuclear Medicine. New York: Springer-Verlag,
1985: 105-120
20. Hutch JA: Vesicoureteral reflux in the paraplegic: Cause and
correction. J Urol 1952; 68: 457-469
21. Wallace DM, Rothwell DL, Williams DI: The long term follow
up of surgically treated vesicoureteral reflux. Br J Urol 1978; 50:
479-484
22. Elder JS: Vesicoureteral reflux. In:Kliegman RM, Behrman RE,
Jenson HB, Stanton BF (eds). Nelson Textbook of Pediatrics.
Philadelphia, PA: Saunders& Elsevier, 2007: 2228-2234
23. Gordon AC, Thomas DF, Arthur RJ, Irving HC, Smith SE: Prenatally
diagnosed reflux: A follow-up study. Br J Urol 1990; 65: 407-412
24. Anderson PA, Rickwood AM: Features of primary vesicoureteric
reflux detected by prenatal sonography. Br J Urol 1991; 67: 267-271
25. Hodson CJ: The radiologic diagnosis of pyelonephritis. Proc R Soc
Med 1959; 52: 669-672
26. Hodson CJ, Maling TM, McManamon PJ, Lewis MG: The
pathogenesis of vesicoureteral reflux nephropathy (chronic atrophic
pyelonephritis). Br J Radiol 1975; 13: 1-26
27. Mendoza JM, Roberts JA: Effects of steril high pressure
vesicoureteral reflux on the monkey. J Urol 1983; 130: 602-606
28. Roberts JA: Vesicoureteral reflux and pyelonephritis in the monkey:
A review. J Urol 1992; 148: 1721-1725
29. Ransley PG, Risdon RA: Reflux nephropathy: Effects of
antimicrobial theraphy on the evolution of the early pyelonephritic
scar. Kidney Int 1981; 20: 733-742
30. Lerner RL, Fleischmann LE, Perlmutter AD: Reflux nephropathy.
Pediatric Clin North Am 1987; 34: 747-770
31. Rolleston GL, Maling TM, Hodson CJ: Intrarenal reflux and the
scarred kidney. Arch Dis Child 1974; 49: 531-539
32. Rose JS, Glassberg KI, Waterhouse K: Intrarenal reflux and its
relationship to renal scarring. J Urol 1975; 113: 400-403
33. Cotran RS: Glomerulosclerosis in Reflux nephropathy. Kid Int
1982; 21: 528-534
34. Tamminen TE, Kaprio EA: The relation of the shape of renal
papillae and of collecting duct openings to intrarenal reflux. Br J
Urol 1977; 49: 345-354
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Türk Nefroloji Diyaliz ve Transplantasyon Dergisi Gökçe İ ve Alpay H : Renal Parenkimal Skar ve Reflü Nefropatisi
Turkish Nephrology, Dialysis and Transplantation Journal
Turk Neph Dial Transpl 2012; 21 (1): 21-27
60. El-Khatib MT, Becker GJ, Kincaid-Smith PS: Reflux nephropathy
and primary vesicoureteric reflux in adults. Q J Med 1990; 77:
1241-1253
61. Nakashima Y, Matsuoka H, Oshima K, Sakamoto K: Progression of
renal disease in patients with reflux nephropathy. Follow-up study.
Nippon Hinyokika Gakkai Zasshi 1997; 88: 557-565
62. Neild GH, Thomson G, Nitsch D, Woolfson RG, Connolly JO,
Woodhouse CR: Renal outcome in adults with renal insufficiency
and irregular asymmetric kidneys. BMC Nephrol 2004; 5:12
63. Sreenarasimhaiah S, Hellerstein S: Urinary tract infections per se do
not cause end stage kidney disease. Ped Nephrol 1998; 12: 210-213
64. Lagomarsimo E, Valenzuela A, Cavagnaro F, Solar E: Chronic renal
failure in pediatrics. Pediatr Nephrol 1999; 13: 288-291
65. Şirin A, Emre S, Alpay H, Nayir A, Bilge I, Tanman F: Etiology of
chronic renal failure in Turkish children. Pediatr Nephrol 1995; 9:
549-552
66. Smellie JM, Edwards D, Normand IC, Prescod N: Effect of
vesicoureteral reflux on renal growth in children with urinary tract
infection. Arch Dis Child 1981; 56: 593-600
67. Smellie JM, Preece MA, Paton AM: Normal somatic growth in
children receiving low dose prophylactic co-trimaxazole. Eur J
Pediatr 1983; 140: 301-304
68. Heidrick WP, Mattingly RF, Amberg JR: Vesicoureteral reflux in
pregnancy. Obstet Gynecol 1967; 29: 571-578
69. Martinell J, Jodal U, Lidin-Janson G: Pregnancies in women with
and without renal scarring after urinary infections in childhood. Br
Med J 1990; 300: 840-844
50. Galanakis E, Bitsori M, Dimitriou H, Giannakopoulou C,
Karkavitsas NS, Kalmanti M: Urine interleukin-8 as a marker of
vesicoureteral reflux in infants. Pediatrics 2006; 117 (5): 863-867
51. Bailey RR: The relationship of vesico-ureteral reflux to urinary
tract infection and chronic pyelonephritis-reflux nephropathy. Clin
Nephrol 1973; 1: 132-141
52. Stefanidis CJ, Siomou E: Imaging strategies for vesicoureteral
reflux diagnosis. Pediatr Nephrol 2007; 22: 937-947
53. Jacobson SH, Eklof O, Eriksson CG, Lins LE, Tidgren B, Winberg
J: Development of hypertension and uraemia after pyelonephritis in
childhood: 27 year follow up. Br Med J 1989; 299: 703-706
54. Smellie JM, Prescod NP, Shaw PJ, Risdon RA, Bryant TN:
Childhood reflux and urinary infection: A follow-up of 10-41 years
in 226 adults. Pediatr Nephrol 1998; 12: 727-736
55. Arar M, Hogg R, Arant BS, Seikaly MG: Etiology of sustained
hypertension in children in the southwestern United States. Pediatr
Nephrol 1994; 8:186-189
56. Vallee JP, Vallee MD, Geenfield SP, Wan J, Springate J:
Contemporary incidence of morbidity related to vesicoureteral
reflux. Urology 1999; 53: 812-815
57. Brakeman P: Vesicoureteral reflux, reflux nephropathy and endstage
renal disease. Adv Urol 2008: 508949
58. Torres VE, Velosa JA, Ilolley KE, Kelalis PP, Stickler GB, Kurtz
SB: The progression of vesicoureteral reflux nephropathy. Ann Int
Med 1980; 92: 776-784
59. Goldraich NP, Barrat TM: Vesicoureteric Reflux and Renal
Scarring, In: Ilolliday MA, Bcrrat TM. Vernier RL (eds). Pediatric
Nephrology: Williams 8 Wilkins, 1987: 647-666

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