Relationship between Microalbuminuria and Creatinine Clearance and the Kidney Scars in Children with Vesicoureteral Reflux

Abstract

Background & Objectives: Vesicoureteral Reflux (VUR) is one of the common urinary tract anomalies that may cause renal parenchymal damages. Recent studies show that microalbuminuria may be helpful in diagnosis of glomerular damage at early stages. The aim of this study was to evaluate the correlation between microalbuminuria and creatinine clearance, kidney scar, in grading of reflux. Methods & Materials: In this cross sectional study 87 children with VUR were studied from 2012 to 2013 in Children’s Hospital of Tabriz/Iran. Three months after treatment of UTI, serum creatinine and urine microalbumin was measured and renal DMSA scan was done in all cases. Results: Mean age of patients was 4.49±2.64 years and 82.8% of them were female. Severity of reflux was mild in 23%, moderate in 33.3% and severe in 43.7% of patients. DMSA scan was abnormal in 58 patients (66.6%). With increase in grading of reflux the amount of albuminuria increased and creatinine clearance decreased but these change were not statistically significant (P=0.12). Urinary albumin in patients with scar (33.32±28.69 mg/24 hr) was significantly higher than patients without scar (10.82±8.83 mg/24 hr) (P=0.006). Frequency of scared kidney in mild, moderate and severe grades of reflux was 50%, 62.1%, and 78.9% respectively (P=0.07). Frequency of microalbuminuria was 31% in patients with scar while only 3.4% of patients without scar had micro albuminuria (P=0.003) Conclusion: We did not find any significant correlation between micro albuminuria, creatinine clearance and abnormality in DMSA scan with reflux grading. However there was a significant correlation between micro albuminuria and scarred kidney. So micro albuminuria may be helpful in diagnosis of renal parenchymal damage. But, further investigations are needed to confirm this finding.