Medikal Teknik Dergisi Kasım 2017 Sayısı

AKTÜEL
Reason for childhood high blood
pressure is kidney reflux
Back flushing of urine stored in the bladder, towards the urinary tracts
and the kidneys is called vesicoureteral reflux (VUR) or kidney reflux.
Istanbul Aydın University Florya Hospital, Urology Specialist Prof. Dr.
Semih Ayan, said this disease is caused more by genetics and can be
diagnosed during pregnancy.
While Kidney reflux makes it
easy for bacteria to reach
the kidney and cause kidney
infections, permanent damage to the
renal tissue, it also opens the way
for kidney functions to deteriorate
and enlarges the kidney through
the urinary tracts. Istanbul Aydin
University Florya Hospital Urology
Specialist Prof. Dr. Semih Ayan noting
that the most important reason is
a birth defect where the tract that
carries the urine meets the bladder,
gave important information related to
this disorder:
The risk of it being seen in a sibling
is 30 percent
Kidney reflux is formed genetically
and because of that, incidents within
a family are higher than normal. A
child with kidney reflux (VUR), having
a sibling with the same affliction is
around 30 percent and because of
that when a child is diagnosed, other
siblings must also be tested.
Diagnosis can be made during
pregnancy
Presently, the serious follow-up
during almost all pregnancies
makes it easier to detect any kidney
problems the baby may have while still
in the mother’s tummy. A number
of fetuses that are sent to us for a
follow-up by obstetricians due to
kidney enlargements are diagnosed
with kidney reflux by tests conducted
after birth. In a baby, who has a
feverish urinary tract infection but
showed no indication before birth,
kidney reflux should be suspected.
It is more common in female
children
The most common patient group
that we see with frequent recurring
infections in the pre-school age
is female children. Day and night
incontinence may be present in
these children and constipation may
accompany thereto. The work for
diagnosis starts with ultrasonography
that has no side effects and harm for
the children and with this method
enlargement of the kidney may be
seen. However, because this finding
will not be present in reflux that is
not advanced, ultrasonography is not
enough for diagnosis. Even though
it is a bit inconvenient for babies and
children, presently the best diagnostic
method for suspicion of kidney reflux,
used all over the world, is a radiology
application where medication is
administered
through a
catheter installed
from the urinary
tract to the
bladder and
visuals taken
during filling and
emptying actions.
The cause of high
blood pressure
in childhood
Our objective in
treatment should
be to understand if there are any
bladder issues that may cause kidney
reflux and if so, to resolve them. If
there is a blockage at the exit from
the bladder it should be eliminated, if
there are excessive contracting taking
place, relaxant drug treatment may
be started. These are the surgical
treatments that are necessary; first
one is when VUR is high level at
time of diagnosis, second one is for
situations where even though it is at
level 3 but it is two sided, or there
is high level of renal tissue loss and
new infections in the kidney cannot
be risked and the third one is due
to infection attacks that cannot be
stopped with anti-biotic treatments.
Also, in children with renal tissue loss
related to VUR, blood pressure must
be monitored regularly. The fact that
one of the leading causes of childhood
high blood pressure is kidney reflux
and scarring developed from past
infections, must never be forgotten.
Kasım 2017
67