Vezikoüreteral reflülü çocuklarda anormal dimercaptosüksinik asit (DMSA) renal tarama bulguları ile ilişkili faktörler

Year 2024, , 488 - 493, 30.09.2024

Hülya Gözde Önal , Yonca Semet

https://doi.org/10.18663/tjcl.1548755

Abstract

Amaç: Bu çalışmada, vezikoüreteral reflü (VUR) tanısı almış çocuklarda anormal dimercaptosüksinik asit (DMSA) tarama sonuçları ile demografik faktörler, VUR şiddeti ve lateralitesine ek olarak idrar yolu enfeksiyonu (İYE) varlığı arasındaki ilişkinin araştırılması amaçlandı.
Gereç ve Yöntemler: VUR tanısı alan 39 çocuk üzerinde retrospektif bir analiz yapıldı. Veriler, yaş, cinsiyet, VUR derecesi, bilateral VUR varlığı ve İYE sıklığını içeriyordu. DMSA taramaları böbrek skarlarını değerlendirmek için kullanıldı. Anormal ve normal DMSA sonuçları olan hastalar arasında istatistiksel karşılaştırmalar yapıldı.
Bulgular: Çocukların ortalama yaşı 30 ay olup, %82’si kızlardan oluşmaktaydı. VUR derecesi III ve üzeri olan hastalarda anormal DMSA bulguları anlamlı şekilde daha yüksek bulundu (%81,5’e karşı %50, p = 0,046). Ancak, gruplar arasında bilateral VUR sıklığı açısından anlamlı bir fark bulunmadı (%33,3’e karşı %41,7, p = 0,618). Anormal DMSA bulguları olan hastalarda İYE sıklığı daha yüksek olmasına rağmen, bu fark istatistiksel olarak anlamlı değildi (%63,0’a karşı %33,3, p = 0,090).
Sonuç: Yüksek VUR dereceleri anormal DMSA sonuçları ile anlamlı bir ilişki göstermektedir. Ancak, bilateral VUR veya İYE sıklığı ile istatistiksel olarak anlamlı bir ilişki gözlenmemiştir. Bulgular, böbrek hasarının ana belirleyicisinin VUR şiddeti olabileceğini göstermektedir.

Keywords

vezikoüreteral reflü, dimercaptosüksinik asit taraması, idrar yolu enfeksiyonları, böbrek skarı

Factors associated with abnormal dimercaptosuccinic acid (DMSA) renal scan findings in children with vesicoureteral reflux

Abstract

Aim: This study aimed to investigate the association between abnormal dimercaptosuccinic acid (DMSA) scan results and demographic factors, vesicoureteral reflux (VUR) severity and laterality, as well as the presence of urinary tract infections (UTIs) in children diagnosed with VUR.
Material and Methods: A retrospective analysis was conducted on 39 children diagnosed with VUR. Data included age, gender, VUR grade, the presence of bilateral VUR, and UTI frequency. DMSA scans were used to assess renal scarring. Statistical comparisons were made between patients with normal and abnormal DMSA results to identify significant predictors of renal damage.
Results: The mean age of the children was 30 months, with 82% being female. VUR Grade III and above was significantly associated with abnormal DMSA findings (81.5% vs. 50%, p = 0.046). However, no significant difference was observed in the frequency of bilateral VUR between groups (33.3% vs. 41.7%, p = 0.618). Although patients with abnormal DMSA findings had a higher incidence of UTIs, this difference was not statistically significant (63.0% vs. 33.3%, p = 0.090).
Conclusion: While higher VUR grades were related to abnormal DMSA results, there was no significant statistical association with bilateral VUR or UTIs. These findings suggest that the severity of VUR may be a more important predictor of kidney damage.

Keywords

Vesicoureteral reflux, DMSA scan, urinary tract infections, renal scarring

Ethical Statement

The study received approval the Ethical Committee of Samsun Training and Research Hospital (Date: 17.10.2017, Decision No. 155).

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