Table 5.

Prevalence of VUR Among Children With UTI

AuthorTitleDesignScoreGradePrevalence of VUR, %Sample SizeAverage
Minimum AgeMaximum AgeFemale, %Comments
Majd et al125 Relationship among vesicoureteral reflux, p-fimbriated Escherichia coli, and acute pyelonephritis in children with febrile urinary tract infectionCohort0.27Poor31.0Children with febrile UTI
et al126
The detection of reflux nephropathy in infants by 99m Technetium dimercaptosuccinic acid studiesClinical trialGood23.8113<1 y47.0
Cohen et al127 Postcircumcision urinary tract infectionsCohort retrospectivePoor13.3169<1 y66.8Children <1 y admitted with UTI
Lomberg and Svanborg128 Influence of P blood group phenotype on susceptibility to urinary tract infectionCohort0.12Fair47.068100.0Referral-selected population, recurrent pyelonephritis
Snodgrass129 Relationship of voiding dysfunction to urinary tract infection and vesicoureteral reflux in children33.0126 wk3 y100.0Referral urologic clinic for UTI
de Man130 Bacterial attachment, inflammation and renal scarring in urinary tract infection26.01970.0First UTI
Chiu et al131 Urinary tract infections in childrenCase seriesPoor34.7231014 y36.2Hospital admission with proven UTI by Cx
Ginsburg and McCracken4 Urinary tract infections in young infantsCase-seriesGood20.9862.1 mo5 d8 mo38.0Hospital with acute UTI
Dickinson132 Incidence and outcome of symptomatic urinary tract infection in childrenCohort0.5 Good7.1414701467.0Symptomatic UTI; Reflux estimated by hydronephrosis (may underestimate)
Elzouki et al93 Symptomatic urinary tract infection in pediatric patients: a developmental aspectCross-sectionalPoor10.75.062<1 mo13 y66.3Symptomatic UTI, inpatient and outpatient
Jodal66 The natural history of bacteriuria in childhoodCohort0.5 Good37.0<10 y81.0Cases of Sx UTI among all children, ie, population-based incidence
Burbige et al133 Urinary tract infection in boysCase series, CohortPoor55.02 wk14 y0.0First UTI
Welch et al134 Recurrent urinary tract infection in girls0.12Poor45.0405 y2 y9 y100.0Recurrent UTI (≥5)
Selkonet et al135 Covert bacteriuria in schoolgirls in Newcastle upon Tyne: a 5-year follow-upCohort0.72Good16.52114 y18 y100.0Asymptomatic
Hashemi119 Recurrent urinary tract infectionCohort: diagnostic test0 Poor31.7412 mo12 y74.0Symptomatic UTI
et al136
Glomerular filtration rate in schoolgirls with covert bacteriuriaCohort0.91Good52.0484 y11 y100.0Covert bacteriuria; may be biased estimate of reflux, not all screened
McKerrow et al3 Urinary tract infection in childrenCohort0.62Fair31.0572013 y60.0Previous confirmed UTI
Verber and Meller7 Development of renal scars after acute nephronia in childhood: a study of sequential DMSA scansCohort0.5 Fair13.42302.04 y12 d4 y?Symptomatic UTI; prevalence based on kidneys
Chao et al85 Vesicoureteric reflux and renal scarring in children: a local perspectiveCohortFair32.915.2 mo
Thelle and Siskjaer137 Combined 99mTc DMSA kidney scintigraphy and [131]Hippuran renography in children with urinary tract infectionsCohort: diagnostic test?Fair37.087male, 3 y; female, 7 y5 mo14 y84.0Referral patients for imaging evaluation
AuthorTitleDesignScoreGradePrevalence of VUR, %Sample SizeAverage
Minimum AgeMaximum AgeFemale, %Comments
Tappin et al138 A prospective study of children with first acute symptomatic E coli urinary tract infectionCohort0.75Good29.0120014 y 74.0
Lanning et al139 Prediction of vesicoureteral reflux children from intravenous urography films19.0
Cremin140 Observations on vesicoureteric reflux and intrarenal reflux: a review and survey materialCohort0.5 Fair37.33131 wk12 y 54.0
Whyte et al141 A protocolCohort0.75Poor20.04602 y7 y?
Ben-Ami et al142 Imaging of children with urinary tract infection: a tailored approachCase reportFair36.0283015 y 81.0First UTI
Drachman et al143 Excretory urography and cystourethrography in the evaluation of children with urinary tract infectionCase seriesFair40.01776 mo12 y 93.0First UTI
Drew and Acton144 Radiological findings in newborn infants with urinary infectionCase series42.0 6418 d 16.0
Moncrieff and Whitelaw145 Value of cystography in urinary tract infectionsCase seriesFair17.0 354.1 y10 d9.5 y 80.0 Embedded Image recurrent UTI
Bourchier et al146 Radiological abnormalities in infants with urinary tract infectionsCase seriesFair to poor36.21003 mo5 d1 y 32.0First UTI
Verber et al147 99mTc dimercaptosuccinic acid (DMSA) scan as first investigation of urinary tract infectionCase seriesGood46.01151.68 y059 y 70.0First UTI
Ring and Zobel148 Urinary infection and malformations of urinary tract in infancyCohortFair19.0140Median,
3 mo
4 d12 mo 45.0First UTI
Verber and Meller149 Serial 99mTc dimercaptosuccinic acid (DMSA) scans after urinary infections presenting before the age of 5 yearsCohort0.75Fair66.0 4512 d4.9 y 67.0First UTI
Ozen and Whitaker150 Does severity of presentation in children with vesicoureteric reflux relate to the severity of the disease or the need for operation?Cohort0.5 Good18.92225.1 y3 mo16 y 61.3First UTI
Cohen49 The first urinary tract infection in male childrenCohort0.62Good26.0 301 mo14 y  0.0First UTI; all boys
Monahan and Resnick151 Urinary tract infections in girls: age at onset and urinary tract abnormalitiesCase seriesGood57.1 212 mo36 mo100.0Recurrent UTI
 8.0 253 y15 y
Mok and White152 The value of radiological investigation in paediatric urinary tract infectionCross-sectional0.18Fair36.11095014 y 80.8Symptomatic UTI
Jequier et al153 The value of ultrasonography as a screening procedure in a first-documented urinary tract infection in childrenCohort0.18Fair39.5 712 d15 y 50.4First UTI; examination at acute phase
Middleton and Nixon154 The lack of correlation between upper tract changes on excretory urography and significant vesicoureteral refluxCase-series22.8391015 yRetrospective, children with UTI examined with IVP + VCUG
Redman and Seibert155 The role of excretory urography in the evaluation of girls with urinary tract infection19.5200<1 y14 y?Referral group, history of UTI, urology department
AuthorTitleDesignScoreGradePrevalence of VUR, %Sample SizeAverage
Minimum AgeMaximum AgeFemale, %Comments
Baker and Barbaris156 Comparative results of urological evaluation of children with initial and recurrent urinary tract infectionCross-sectionalGood43.02391 y12 y 83.7Initial or recurrent UTI
Kenda et al157 Renal ultrasound and excretory urography in infants and young children with urinary tract infectionCohortFair68.0
2 wk
13 mo
1 y
6 y
Smellie et al158 Children with urinary infection: a comparison of those with and without vesicoureteric refluxCohort0.5 Fair33.0744012 y 76.0Bacteriologic UTI; half asymptomatic
Johnson et al159 Identification of children requiring radiologic evaluation for urinary infectionCohort0.5 Good12.0 692 wk13 y 91.0Symptomatic outpatients with UTI
Traisman et al160 The localization of urinary tract infection with 99mTc glucoheptonate scintigraphyCohort: diagnostic test0.9 Good42.0 19Median 3 y + 11 mo3 d19 y 79.0Chart review, does not specify site
Marshall et al161 Vesicoureteric reflux in children: prediction with color Doppler imagingCohort: diagnostic test0.72Good25.062 ureters26 d9 y 74.0Radiographic studies at small hospital; history of IUTI
Blickman et al162 Voiding cystourethrography: the initial radiologic study in children with urinary tract infectionCase seriesFair34.13891 wk6 y?Review of records of children with UTI and urography
Kangarloo et al163 Urinary tract infection in infants and children evaluated by ultrasoundCase seriesFair15.2 591 d18 y?Radiology department; review of patients with UTI
Isdale164 The role of radiology in urinary tractCohort0.66Fair13.0 5401 y 65.0Radiology department review of
 infection in children 7.0 431 y3 y  urograms, most UTI; may be a
 9.0 353 y5 y fairly selected population
 8.0 285 y7 y
 9.0 707 y14 y
McDonagh and Bell165 Urinary tract infection in a peripheral paediatric unitCohort0.5 Fair34.0334014 y 75.0Review chart study
Tsai166 Vesico-ureteral reflux in infants and childrenCohortFair12.8188Infants and children?? 54.0Referred to urologic clinics
Gross and Lebowitz167 Infection does not cause refluxCohort0.62Good33.96016 y1 wk30 y 72.0Radiology department review of charts
Bisset et al71 Urography and voiding cystourethrography: findings in girls with urinary tract infectionCase seriesGood36.05235.3 y1 mo18 y100.0Radiology department review of charts
Strife et al168 Nuclear cystography and renal sonography: findings in girls with urinary tract infectionCohortFair31.04554.6 y1 mo18 y100.0Review of charts (urograms)
Tam et al169 Role of renal ultrasonography (RUS) and micturating cystourethrogram (MCU) in the assessment of vesico-ureteric reflux (VUR) in children and infants with urinary tract infection (UTI)Clinical trialFair30.9 551.7 y1 mo11 y 33.0Confirmed UTI
Principi et al170 Radiological investigations and firstCross-sectionalGood55.9 5915 d8 y 67.8First symptomatic UTI
 symptomatic urinary tract infection in85.0 2001
 infants and children57.9 1923
25.0 2048
AuthorTitleDesignScoreGradePrevalence of VUR, %Sample SizeAverage
Minimum AgeMaximum AgeFemale, %Comments
et al171
Genitourinary tract anomalies in Thai children with urinary tract infectionCase seriesGood11.8110? 015 y 61.0First UTI
Marild et al172 Fever, bacteriuria and concomitant disease in children with urinary tract infectionCohort0.5 Fair28.01122 mo<6 y 75.0Prospective study; inpatients and outpatients with UTI were actively surveyed
Hodson and Wilson173 Natural story of chronic pyelonephritic scarringCross-sectional0.33Poor34.016512 yRetrospective study based on radiology findings
Rushton et al174 Renal scarring following reflux and nonreflux pyelonephritis in children: evaluation with 99 Tc-dimercaptosuccinic acid scintigraphyCohort0.62Fair36.466 kidneys3.5 y1.5 y15 y 66.0Prevalence among kidneys; therefore, may be overestimated
Alon et al175 Ultrasonography in the radiologic evaluation of children with urinary tract infectionCohort1  Good22.2 814.8 y2 wk12 y 81.4Documented UTI, inpatients and outpatients
Johnson et al176 Renal ultrasound evaluation of urinary tract infections in childrenCohort0.54Fair17.0 64
Hellstrom et al52 Voiding cystourethrography as a predictor of reflux nephropathy in children with urinary-tract infectionCohort0.91Good32.0 8410 mo2 mo6 y 74.0Febrile first documented UTI
Honkinen et al68 Ultrasonography as a screening procedure in children with urinary tract infectionCohort0.75Fair36.8 76? ? ? ? Symptomatic UTI
Melis et al177 Involvement of the renal parenchyma in acute urinary tract infection: the contribution of 99m Tc dimercaptosuccinic acid scanCohort (retrospective)0.45Fair26.01961 wk16 y 61.0Inpatients from pediatric hospital
Bergstrom et al178 Symptomatic urinary tract infection in boys in the first year of life with special reference to scar formationCohort0.5 Fair30.8 521 mo12 mo  0.0First UTI, in boys, inpatients
Gleeson andImaging in urinary tract infectionCohort37.2188 65.0Hospitalized patients; outpatients
 Gordon72 48.11 also?
Rickwood et al179 Current imaging of childhood urinary infections: prospective surveyCross-sectional0.6625.520010 y 41.0Symptomatic UTI, emergency and outpatients
Kunin et al180 Urinary tract infection in school children: an epidemiologic, clinical and laboratory studyCohort1 Good18.7107X 5 y19 y100.0School children, mostly asymptomatic
Kunin181 Urinary tract infections in childrenReviewGood22.7 222 y5 y100.0Preschool girls
Jequier et al153 The value of ultrasonography as a screening procedure in a first-documented urinary tract infection in childrenCross-sectional0.66Fair39.4 712 d15 y 50.0First UTI, inpatients and outpatients
Hoberman et al182 Oral vs intravenous therapy for acute pyelonephritis in childrenProspective cohortGood44.0 781 mo24 mo??Emergency department; abstract only