VURx is a validated tool that reliably predicts spontaneous vesicoureteral reflux(VUR) resolution or ≥2 grade improvement when diagnosed <24 months old. We aimed to study the VURx in children >2 years of age.
Children diagnosed with primary VUR at >24 mo with ≥2 voiding cystourethrograms <18 yo were identified and scored with the VURx, a 6-point scale based on gender, reflux grade, ureteral abnormalities, and reflux timing. Proportional sub-distribution hazard models for competing risks identified variables associated with resolution/improvement at different time points.
271 patients (21M, 250F) met inclusion criteria; mean age 4.0±2.1 years, median VUR grade 2. Resolution/improvement by VURx was: 1- 1(100%); 2- 25(67.6%); 3- 48(37%); 4- 18(21.4%); 5/6- 4(18.2%). Female gender (p=0.005) and VUR timing (late-filling, p=0.002; early/mid-filling, p=<0.001) independently predicted non-resolution. Median resolution time(months) based per VURx was: ≤2- 15.6(95%CI 11.0-13.8); 3- 34.7(25.4-44.1); 4- 55.9(40.1-inf); ≥5- 30.3(29.5-inf). High-grade(IV/V) VUR was not associated with resolution at any point. Ureteral abnormalities were associated with lack of resolution in the first 12 -18 months (HR=0.29; 95% CI(0.29-0.80)) but not in later follow-up. VURx scores of 3, 4 and 5 were significantly associated with lack of resolution/improvement compared to VURx score ≤2 (p = 0.031).
VURx reliably predicts primary VUR improvement/resolution in children diagnosed at ≥24 mo. Spontaneous resolution/improvement is less likely as VURx score and time from diagnosis increase.
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 December 2018.
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