Resolución espontánea de reflujo vesicoureteral primario en niños: factores predictores y nomograma de predicción

Abstract

Introduction: To determine primary vesico-ureteral reflux (VUR) resolution rate in a population of children younger than five years of age, as well as, factors predicting such presentation. Furthermore, based on these results, to design a nomogram which allows prediction of spontaneous resolution likelihood within a 3 years period from diagnosis. Methodology: 407 children with primary vesicoureteral reflux diagnosed within a ten years period were included. Through association analysis and average comparison, variables acting as risk factors for spontaneous resolution failure were determined. Additionally, using binomial regression models associations were verified. We practice comparisons through ANOVA or t-test, as well as Log Rank Test survival analysis in order to determine variables affecting spontaneous resolution length. Results: Spontaneous resolution rates were 92%, 85%, 56.4%, 21% and 5% for VUR grade I to V respectively. Multivariate analysis demonstrated that reflux uropathy (sig=0,000), dysfunctional evacuation syndrome (DES) (sig=0,000) and bilateral compromise acted as the principal independent risk factors for spontaneous resolution failure. Nevertheless, survival analysis established that DES was the only risk factor affecting spontaneous resolution length (sig=0,002). Discussion: Our analyses confirm that inclusion of variables as DES, reflux uropathy and bilateral compromise is indispensable for VUR spontaneous resolution prediction.