The postoperative change of renal function in children with vesicoureteral reflux

It is thought that the long term observation was necessary for the postoperative patients with vesicoureteral reflux (VUR), since long term prognosis is vague and some of them with preserved renal function in the initial stage even might develop progressive renal dysfunction. We performed a retrospective study to clarify this problem. We analyzed changes in the %Cr (basal serum creatinine value/measured serum creatinine value ´ 100%) of 199 patients observed postoperatively more than 5 years between 2000 and 2005 in our hospital. Of 199 patients, 135 (68%) were male, 159 (80%) had bilateral VUR. Median age was 3 years at the surgery (range 0.4 - 16.5 years) and median observational duration was 10 years (range 5.0 - 15.2 years). VUR disappeared in 97.5%. Fifty one out of 199 patients had eGFR less than 90 ml/min/1.73 m 2 at last-observation, and their mean %Cr was 77% preoperatively, 85% at 2 years after the operation, and 75% at last-observation. %Cr was significantly lower at last than 2 year-postoperative observation in them. This report shows that kidney function declined after the operation in many patients even if renal function is maintained for a short period of time.