Renal Scarring in the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) Trial

• DOI: 10.2215/cjn.05210515
• Publication Date: 2015-11-11T01:48:19Z
• Authors: Tej K. Mattoo; Russell W. Chesney; Saul P. Greenfield; Alejandro Hoberman; Ron Keren; Ranjiv Mathews; Lisa Gravens-Mueller; Anastasia Ivanova; Myra A. Carpenter; Marva Moxey-Mims; Massoud Majd; Harvey A. Ziessman
• Keywords: Male; Vesico-Ureteral Reflux; Infant; 16. Peace & justice; 3. Good health; Cicatrix; 03 medical and health sciences; 0302 clinical medicine; Anti-Infective Agents; Recurrence; Child, Preschool; Urinary Tract Infections; Humans; Female; Kidney Diseases

Background and objectives The main of the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial were to evaluate role antimicrobial prophylaxis in prevention recurrent urinary tract infection (UTI) renal scarring children vesicoureteral reflux (VUR). We present a comprehensive evaluation outcomes RIVUR participants. Design, setting, participants, & measurements This multicenter, randomized, placebo-controlled enrolled 607 aged 2–71 months grade 1–4 VUR diagnosed after first or second febrile symptomatic UTI. Study participants received trimethoprim-sulfamethoxazole placebo followed 2 years. Renal was evaluated by baseline follow-up 99mtechnetium dimercaptosuccinic acid (DMSA) scans that reviewed independently two blinded reference radiologists. Results At end study, 58 (10%) 599 63 (5%) 1197 units had scarring. New did not differ between groups (6% versus 7%, respectively). significantly older (median age, 26 11 months; P=0.01), UTI before enrollment (odds ratio [OR], 2.85; 95% confidence interval [95% CI], 1.38 5.92), more likely be Hispanic (OR, 2.22; CI, 1.13 4.34), higher grades 2.79; 1.56 5.0). proportion new scars 4 than no 24.2; 6.4 91.2). Conclusions Significantly seen relatively those episode randomization. Preexisting occurred low-grade VUR. Antimicrobial decrease risk