Childhood Kidney Diseases

Korean Society of Pediatric Nephrology (대한소아신장학회)
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Vesicoureteral Reflux and Urinary Tract Infection in Children with Congenital Hydronephrosis

선천성수신증 환아에서 방광요관역류 및 요로감염 발생에 대한 고찰

  • Kim, Jong-Ho (Department of Pediatrics, Ajou University School of Medicine) ;
  • Kwak, Jae-Reyung (Department of Pediatrics, Ajou University School of Medicine) ;
  • Park, Jee-Min (Department of Pediatrics, Ajou University School of Medicine) ;
  • Pai, Ki-Soo (Department of Pediatrics, Ajou University School of Medicine)
  • 김종호 (아주대학교 의과대학 소아과학교실) ;
  • 곽재령 (아주대학교 의과대학 소아과학교실) ;
  • 박지민 (아주대학교 의과대학 소아과학교실) ;
  • 배기수 (아주대학교 의과대학 소아과학교실)
  • Published : 2009.10.31
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Abstract

Purpose : We checked voiding cystourethrography (VCUG) in patients with congenital hydronephrosis (CHN) and followed up the occurrence of urinary tract infection(UTI) in these patients. And we tried to figure out the relationship between CHN and VUR and UTI. Methods : We performed a retrospective study in 122 CHN patients who received VCUG from 2002 to 2008 at Ajou University Hospital. We executed logistic regression, chi-square test and T-test using version 16.0 SPSS package for the statistical analysis. P<0.05 was regarded as significant. Results : Most patients with CHN were male (73%) and there was a tendency of preferences for unilateral (77%) and left (84%) occurrence of hydronephrosis. The incidence of VUR was 18.9% among 122 CHN patients and no laterality difference was found to the severity of VUR or hydronephrosis. The incidences of VUR and UTI was higher in group of higher grade (III-IV) CHN patients, when compared to the lower group, respectively. When VUR was present in CHN patients, the incidence of UTI during infancy was also higher. Conclusion : The incidence of VUR was higher in patients with higher grades of CHN. The incidence of UTI during infancy was higher when VUR was present in the CHN patients.

목적 : 선천성 수신증 환아에서 방광요관역류(VUR)가 어떠한 관련이 있는지 또한 요로감염 발생 여부와 어떠한 연관이 있는지 정보가 부족하다. 이에 연구자들은 VCUG를 시행 받은 선천성 수신증 환아를 대상으로, 수신증과 VUR 간의 연관성 및 요로감염 발생 여부에 대하여 분석을 하여 환자관리에 도움이 되는 정보를 마련하고자 하였다. 방법 : 연구는 2002년 1월 1일부터 2008년 12월 31일까지 아주대학교 병원에서 선천성 수신증으로 진단된 생후 1개월 이내의 환아 중, VCUG를 시행 받은 122명을 대상으로 후향적 연구를 하였다. 측정치의 통계분석은 SPSS version 16.0을 사용하여 logistic regression, T-test, chi-square test 등을 실시하였으며, P<0.05인 경우 통계학적으로 유의한 것으로 평가하였다. 결과 : 총 122명의 선천성 수신증 환자 중 남자가 많았고(73%), 주로 편측 수신증을 가진 환자가 많았으며(77%), 그 중 좌측(84.0%) 수신증 환자가 유의하게 많았다. VUR은 총 23명(18.9%)에서 발견되었다. 수신증의 심한 정도는 좌우측에 따른 차이를 보이지 않았으며, VUR의 정도도 좌우측에 따른 차이를 보이지 않았다. 수신증을 1-4단계로 나누었을 때, 각 단계별로 VUR의 발생빈도 차이는 관찰할 수 없었으나, 수신증을 경한 수신증(1-2단계)과 중한 수신증(3-4단계)으로 나누었을 때 중한 수신증에서 VUR의 발생 빈도가 유의하게 높음을 확인할 수 있었다. 또한 영아기 동안에 요로감염 발생을 살펴보면, 수신증이 심하거나 VUR이 있을 경우 그 발생빈도가 높았다. 결론 : 선천성 수신증 환아에서 수신증의 정도가 심할 경우 더욱 VUR의 빈도가 더 높았으며, VUR이 존재할 경우 영아기에 요로감염이 더 흔히 발생함을 알 수 있었다.

Keywords

References

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