AUA: Vesicoureteral Reflux (2017): Difference between revisions

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****'''Children with VUR but without bilateral renal abnormalities''' to establish an estimate of glomerular filtration rate (GFR) for future reference.
****'''Children with VUR but without bilateral renal abnormalities''' to establish an estimate of glomerular filtration rate (GFR) for future reference.
* '''<span style="color:#ff0000">Urinalysis'''
* '''<span style="color:#ff0000">Urinalysis'''
**Evaluate for proteinuria and bacteriuria''';''' if the urinalysis indicates infection, a urine culture and sensitivity is recommended
**'''Evaluate for proteinuria and bacteriuria'''
***If the urinalysis indicates infection, a urine culture and sensitivity is recommended


=== Imaging ===
=== Imaging ===
* '''<span style="color:#ff0000">Recommended (1)''':
* '''<span style="color:#ff0000">Recommended (1)''':
**'''<span style="color:#ff0000">Renal ultrasound'''  
*#'''<span style="color:#ff0000">Renal ultrasound'''  
***VUR and UTI may affect renal structure and function
*#*VUR and UTI may affect renal structure and function
* '''<span style="color:#ff0000">Optional (1)'''
* '''<span style="color:#ff0000">Optional (1)'''
**'''<span style="color:#ff0000">DMSA</span>''' (technetium-99m-labeled dimercaptosuccinic acid)  
*#'''<span style="color:#ff0000">DMSA</span>''' (technetium-99m-labeled dimercaptosuccinic acid)  
***'''To assess the status of the kidneys for scarring and function'''
*#*'''To assess the status of the kidneys for scarring and function'''
**** '''Children with higher grades of VUR (i.e. grades III to V) are at greater risk of having renal cortical abnormalities.'''
*#** '''Children with higher grades of VUR (i.e. grades III to V) are at greater risk of having renal cortical abnormalities.'''
**** DMSA scanning can be useful to identify pre-existing abnormalities.
*#** DMSA scanning can be useful to identify pre-existing abnormalities.


== Initial Management of the Child with VUR ==
== Initial Management of the Child with VUR ==