LONG-TERM FOLLOW-UP OF INFANTS WITH GROSS VESICOURETERAL REFLUX
LONG-TERM FOLLOW-UP OF INFANTS WITH GROSS VESICOURETERAL REFLUX
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DOI：
10.1016/s0022-5347(17)37010-6
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发表时间：
1992-11-01
影响因子：
6.6
通讯作者：
SMITH, AH
中科院分区：
文献类型：
--
作者：
BAILEY, RR;LYNN, KL;SMITH, AH
大多数患有严重膀胱输尿管反流的儿童（1岁或以下）在出现时已经有肾损害，或者在生命的最初几年内发生反流性肾病。我们报告了1952年至1970年间31例（16名男孩）婴儿期出现的大体膀胱输尿管反流（Roldham分类）的长期随访。他们总共有44个大体输尿管狭窄（13个双侧，18个单侧），年龄在1天到48周之间（平均15.3周）。在31名婴儿中，5名在出生后一年内死亡，4名在失访前接受了长达11年的随访，1名在随访19.5年后死于机动车事故。其余21例患者随访16 - 37年（平均23.9年），4例肾脏正常，13例单侧和4例双侧反流性肾病。在患有单侧反流性肾病的患者中，1名先天性单肾患者出现蛋白尿、高血压和肾衰竭，目前正在接受血液透析，而另外2名患者的舒张压为90毫米汞柱或更高。在4例双侧反流性肾病患者中，2例出现蛋白尿和肾功能不全，1例进展为终末期肾衰竭。在出生后第一年内出现严重膀胱输尿管反流的婴儿，如果在就诊时没有严重的双侧反流性肾病，则表现良好。反流性肾病患者应定期接受肾脏学监测，特别注意蛋白尿、肾功能和血压。
The majority of children (1 year old or less) with gross vesicoureteral reflux already have renal damage at the time of presentation or reflux nephropathy develops during the first few years of life. We report the long-term followup of 31 patients (16 boys) presenting in infancy with gross vesicoureteral reflux (Rolleston classification) between 1952 and 1970. They had a total of 44 grossly refluxing ureters (13 bilateral, 18 unilateral) and presented between ages 1 day and 48 weeks (mean 15.3 weeks). Of the 31 infants 5 died within the first year of life, 4 were followed for up to 11 years before being lost to followup and 1 was killed in a motor vehicle accident after 19.5 years of followup. The remaining 21 patients have been followed for 16 to 37 years (mean 23.9 years); 4 have normal kidneys, and 13 have unilateral and 4 have bilateral reflux nephropathy. Of those patients with unilateral reflux nephropathy proteinuria, hypertension and renal failure developed in 1 born with a single kidney and he is now on hemodialysis, while 2 others have a diastolic blood pressure of 90 mm. Hg or greater. Of the 4 patients with bilateral reflux nephropathy 2 have proteinuria and renal insufficiency, with 1 progressing towards end stage renal failure. Infants who present with gross vesicoureteral reflux within the first year of life appear to do well if free of severe bilateral reflux nephropathy at presentation. Patients with reflux nephropathy should remain under regular nephrological supervision with particular attention given to proteinuria, renal function and blood pressure.