Risk Factors for Atrophic Renal Scar.
- Author:
Jung Won LEE
1
;
Hyun Jin KIM
;
Seoung Joo LEE
Author Information
1. Department of Pediatrics, Seoul Municipal Dongbu Hospital, Seoul, Korea.
- Publication Type:Webcasts ; Original Article
- Keywords:
Atrophic renal scar;
Congenital;
Gender;
Vesicoureteral reflux;
ACE gene polymorphism
- MeSH:
Age Distribution;
Child;
Cicatrix*;
Female;
Follow-Up Studies;
Humans;
Hypertension;
Kidney Failure, Chronic;
Male;
Pyelonephritis;
Retrospective Studies;
Risk Factors*;
Technetium Tc 99m Dimercaptosuccinic Acid;
Urinary Tract Infections;
Vesico-Ureteral Reflux
- From:Journal of the Korean Society of Pediatric Nephrology
2005;9(2):193-200
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: An atrophic renal scar(RS) is one of the underlying causes for childhood hypertension and chronic renal failure. The risk factors for atrophic renal scar were evaluated. METHODS: 41 children, who presented with first febrile urinary tract infection at the Ewha Womans University Hospital between 1995 and 2003 and had generalized atrophic RS on 99mTc-DMSA renal scan, were retrospectively studied. Atrophic RS was divided into severe atrophic RS(n=14) if relative uptake on renal scan was below 10%, or mild atrophic RS(n= 27) if relative uptake on renal scan was between 10-35%. RS was defined as congenital if the scar was detected on the first renal scan, and as acquired if the scar developed on the follow-up renal scan from acute pyelonephritis of the first renal scan. The control group was consisted of randomly selected 41 children with segmental RS. The risk factors for atrophic RS such as the generation time, VUR, gender and ACE gene polymorphism were evaluated. RESULTS: The age distribution of atrophic RS and segmental RS did not differ significantly (P>0.05). The rate of congenital RS in atrophic RS was 61.0%(25/41), which was significantly higher than 9.8%(4/41) of segmental RS(P<0.01). Atrophic RS developed more frequently in male children(M:F 68.3%:31.7%) than segmental RS(M:F 41.4%:58.6%)(P<0.05). Vesicoureteral reflux(VUR) was found in 92.7%(38/41) of the atrophic RS, which was significantly higher than 53.7%(22/41) of segmental RS(P<0.05). In children without VUR, the male to female ratio did not differ between atrophic RS and segmental RS(P>0.05). But in children with VUR, there was a higher proportion of males with severe atrophic RS than segmental RS(85.7%:45.5%). ACE gene polymorphism did not differ between the atrophic and segmental RS groups, irrespective of the presence of VUR(P>0.05). CONCLUSION: Most atrophic RSs were congenital which could not be preventable postnatally and the major risk factors were VUR and the male gender. ACE gene polymorphism was not the significant risk factor for an atrophic RS.
