Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
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Correlation between the Severity of Hydronephrosis and the Presence of VUR in Neonate

신생아에서 수신증의 심한 정도와 방광요관역류 존재와의 연관성

  • Lee, Hyo-Jung (Department of Pediatrics, College of Medicine, Chonbuk National University) ;
  • Noh, Seong-Hoon (Department of Pediatrics, College of Medicine, Chonbuk National University) ;
  • Lee, Soo-Yeon (Department of Pediatrics, College of Medicine, Chonbuk National University) ;
  • Kim, Min-Sun (Department of Pediatrics, College of Medicine, Chonbuk National University) ;
  • Lee, Dae-Yeol (Department of Pediatrics, College of Medicine, Chonbuk National University)
  • 이효정 (전북대학교 의학전문대학원 소아과학교실) ;
  • 노성훈 (전북대학교 의학전문대학원 소아과학교실) ;
  • 이수연 (전북대학교 의학전문대학원 소아과학교실) ;
  • 김민선 (전북대학교 의학전문대학원 소아과학교실) ;
  • 이대열 (전북대학교 의학전문대학원 임상의학연구소)
  • Published : 2009.04.30
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Abstract

Purpose : The increasing use of ultrasonography has allowed for an increase in the of the detection of congenital hydronephrosis, and the clinical outcomes of congenital hydronephrosis are widely varied. In this study, the necessity of voiding cystourethrography in neonate with hydronephrosis to rule out vesicoureteral reflux (VUR) was evaluated. Methods : Between January 2004 and December 2007, we reviewed the medical record of 157 childrens with congenital hydronephrosis detected within 1 month of age. The severity of hydronephrosis was graded by SFU (Society of Fetal Urology) system, and anterior posterior pelvic diameter (APPD). We evaluated the relationship between severity of hydronephrosis and incidence of VUR by using SPSS windows version 16.0. A P-value<0.05 is considered to be statistically significant. Results : Total renal unit number was 254, and 20(7.8%) renal units had VUR. We did not find any relationship between hydronephrosis grade the presence of VUR grade (P>0.05). In addition, there was no statistical significance between APPD, laterality of hydronephrosis and VUR incidence. However, renal units with VUR had lower spontaneous resolution rate (P<0.05), compared to renal units without VUR. Conclusion : In this study, there was no statistical significance between the severity of hydronephrosis and presence of VUR. Therefore, voiding cystourethrogram is recommended for all children with hydronephrosis to rule out VUR, regardless of the severity of hydronephrosis.

목 적 : 산전 초음파 이용의 증가로 인하여 선천성 수신증 발견 빈도가 증가하고 있고 VUR이 수신증의 원인 중 하나이다. 본 연구에서는 선천성 수신증의 정도와 VUR의 연관성을 조사하여 배뇨성 방광요도 조영술의 필요성을 알아보고자 하였다. 방 법 : 2004년 1월 1일 부터 2007년 12월 31일 까지 생후 1개월 이내에 선천성 수신증이 진단된 157명의 환아 254구의 신장을 대상으로 수신증의 등급 및 신우 전후직경이 VUR의 빈도와 연관성이 있는지를 연구하였다. 통계 분석은 SPSS 16.0을 이용하여 Chi-Square 법, ANOVA 법으로 분석하였으며, P값이 0.05 미만인 경우를 통계적으로 유의한 것으로 분석하였다. 결 과 : 수신증이 있는 254구의 신장 중 7.8%에 해당하는 20구의 신장에서 VUR이 동반되었다. 수신증 등급과 신우 전후직경은 VUR의 빈도와는 의미있는 상관관계가 없었고, 좌측이 우측보다 수신증의 정도와 VUR 등급이 유의하게 높았으며 VUR이 존재하는 경우 수신증의 자연 소실률이 현저히 낮은 것으로 나타났다. 결 론 : 본 연구에서 수신증 등급과 VUR의 유무와는 통계적 유의성이 없었다. 따라서 수신증의 심한 정도에 관계없이 모든 환아에서 VUR 유무를 확인하기 위해 배뇨성 방광요도조영술은 시행되어야 한다.

Keywords

References

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  1. 선천성수신증 환아에서 방광요관역류 및 요로감염 발생에 대한 고찰 vol.13, pp.2, 2009, https://doi.org/10.3339/jkspn.2009.13.2.222