膀胱尿管逆流症の治療I : 年齢及び術後腎機能回復よりみた保存的療法の限界

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The limit for conservative treatment of VUR in infants and children was studied. In consideration of age and renal function, as indices of renal function, renal ratio (renal growth), β_2-MG urinary ratio (renal tubular damage) and DMSA renal uptake rate (renal cortical damage) were used. Small kidney below 2 SD of renal ratio had difficulty in recovering renal growth even after disappearance of VUR and showed about 17% or less in DMSA renal uptake rate. Refluxing kidney of 17〜18% in DMSA renal uptake rate showed marked post-operative recovery of renal function compared with those of less than 17%. The cases showing more than 1.0 of β_2-MG urinary ratio revealed severe renal dysfunction from the aspect of renal growth and DMSA renal uptake rate. Renal function was relatively well in cases with β_2-MG urinary ratio of 0.33 acd 1.0. Those results indicate that 18 acd 20% in DMSA renal uptake rate and 0.33〜1.0 in β_2-MG urinary ratio are considered the limit for reversible renal dysfunction. Renal ratio,β_2-MG urinary ratio, DMSA renal uptake rate reflect the timing oi varying renal dysfunction, and it is nesessary to make judgment on overall estimation of these three indices. Severe renal dysfunction was noted even in infants of less than 3 years, but these cases (compared with those of more than three years) showed marked recovery of renal function after antireflux operation. It was considered necessary to select an appropriate treatment for VUR before age of three years.
特定非営利活動法人日本小児外科学会の論文
1986-11-02

膀胱尿管逆流症の治療I : 年齢及び術後腎機能回復よりみた保存的療法の限界

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