Children with urinary infection: A comparison of those with and those without vesicoureteric reflux

Abstract

In view of the importance of making an early diagnosis of vesicoureteric reflux (VUR), a retrospective study was made of 744 children aged 0 to 12 years seen at University College Hospital between 1955 and 1975 with proven urinary tract infection. One third had VUR. There was no significant difference in the sex or age of presentation between those with and without VUR but fever was more often a presenting symptom in those with VUR. This difference was significant when renal scarring was also present. There was no other clear clinical difference between the two groups at the time of the presentation. In our study 570 children were followed for at least one year, and about 200 for 10 to 20 years, so that a comparison was also possible between the associations, response to treatment, and progress of children with and without reflux. Renal scarring was found almost exclusively in children with VUR; the only 2 fresh scars observed developed in boys with moderate to severe reflux following infection. Hypertension developed only in children with renal damage, irrespective of the presence or absence of VUR. The early recognition, treatment, and investigation of infants and young children with urinary infection remains imperative.