VURx is a novel tool designed to predict spontaneous reflux resolution in children <2 years of age. We performed a multi-institutional validation study to confirm the discriminatory power of VURx in predicting vesicoureteral reflux (VUR) resolution rates in young children.
Children diagnosed with primary VUR before 24 months of age with ≥2 voiding cystourethrograms (VCUGs) were identified. Demographics, VUR grade and timing, ureteral anomalies, and radiographic outcomes were evaluated. Concordance index (C-index) was estimated for time to event model assessment.
Three hundred and sixty-nine children (219 girls, 150 boys) met inclusion criteria. Mean age at diagnosis was 4.7 ± 4.9 months. One hundred and one patients (27.4%) had early to mid-filling, 214 (58%) late filling and 54 (14.6%) had voiding only VUR. Eighty-seven children (23.6%) had high-grade reflux. Ureteral anomalies were observed in 50 children (13.6%). VURx 1 to ≥5 had improvement/resolution rates of 88.2%, 77.3%, 62.3%, 32.1% and 14.3%, respectively. Children with filling phase VUR (p<0.001), grade 4-5 reflux (p<0.001), and ureteral anomalies (p=0.003) had significantly longer median times to resolution on time to event analysis. Median time to spontaneous resolution was 12.6, 12.7, 15.1, 25.6 and >31 months for VURx 1 to ≥5, respectively. C-index was 0.305 (95% CI, 0.252-0.357). Sixty-five children (17.6%) underwent surgical intervention during the study period.
VURx is a simple tool that reliably predicts significant improvement and spontaneous resolution of primary reflux in children diagnosed at <2 years. VURx provides valuable prognostic information, facilitating individualized patient care.
This research output has an Altmetric Attention Score of 4. 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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#11,806,330
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#82
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