대구, 경북지역에서의 사춘기 이전 소아에서 임상 적응증, 성별 및 나이에 따른 방광요관역류의 빈도

Abstract

Purpose: The prevalence of vesicoureteral reflux (VUR) in prepuberty children with urinary tract infection (UTI) varies among the different racial groups. The purpose of this study was to determine if the incidence of VUR is associated with age, gender and the clinical indications for the prepuberty children with UTI in Daegu city and the Gyeongbuk area, and we wanted to compare our findings to those reported findings for the other racial groups. Materials and Methods: The medical records of all 2,474 prepuberty children who underwent a voiding cystourethrogram(VCUG) or radionuclide cystogram (RNC) between 1998 and 2003 were retrospectively reviewed. Age, gender and the clinical indications were recorded for the first VCUG or RNC. For the children with UTI, the highest grade of VUR and the number of UTIs were also examined. We analyzed the data by using chi square test and calculating the odds ratio with using SAS version 8.12. Results: There were 2,037 prepuberty children with UTI (82.5%) among the 2,474 total subjects. Among the participants, 718 (35.2%) were female and 1,306 (64.1%) were male, and 13 were missing data. The overall rate of VUR was 21.2% (432/2,037) with a rate of 22.6% (162/718) for the females and 20.4% (267/1,306) for the males, respectively. With respect to the age distribution, none were younger than 1, 1 was younger than 2, the 2-6 year-olds were 17.3% (257/1,485), and the 7-12 year olds were 35.9% (103/287). Referring to the frequency of UTI, the patients experiencing their first, second. third, fourth, and over five episodes were 16.8%, 34.2%, 36.7%, 42.9% and 56.1%, respectively. As the patients got older, the first VCUG was done for recurrent UTI (p＜0.05). Conclusions: We investigated the rate of VUR based on the clinical indications, age and gender among Korean preadolescents. The rate of reflux was 21.2% for the patients suffering with UTI. The female had VUD 1.1 times more frequent than did the males. The older patient had a higher reflux rate, which suggested that prepuberty children over 1 year of age with recurrent UTI should undergo their first VCUG or RNC. (Korean J Urol 2005;46:1284-1289)