The most significant risk factors for renal scarring in children with primary vesicoureteral reflux (VUR) are high-grade reflux, age at VUR diagnosis greater than five years, and male gender, according to a report in Nephrology (2008;13:38-42).
Prayong Vachvanichsanong, MD, and colleagues at the Prince of Songkla University in Hat Yai, Thailand, studied 98 children with VUR and who had 99 m technetium-labelled dimercaptosuccinic acid (DMSA) renal scans. The group consisted of 46 boys and 52 girls. Their mean ages at VUR diagnosis was 1.1 and 2.9 years, respectively. The ages at they underwent DMSA scans were 3.3 and 4.8 years, respectively.
Renal scarring was 14.5 times more likely to occur in subjects with high-grade reflux than in patients with low-grade reflux, 12.6 times more likely to occur in patients older than five years at VUR diagnosis than in those younger than six months, and 6.5 times more likely to occur in boys than girls.