Does hydronephrosis predict the presence of severe vesicoureteral reflux?

Unlabelled: We hypothesized that, in patients with vesicoureteral reflux (VUR) grade IV or V, hydronephrosis will likely be found, if the patient has a full bladder during the renal ultrasound examination. Eight hundred thirty-seven patients were included in the study. Patients ranged in age from <1 month to 18.7 years, with a median age of 1.3 years. Five hundred sixty-nine were female and 268 were male. In this retrospective study, each patient underwent a voiding cystourethrogram (VCUG) and a renal ultrasound examination. The presence of hydronephrosis and bladder filling status in 131 renal units with VUR grade IV or V was evaluated. Sensitivity and specificity for hydronephrosis to detect the presence of VUR grades IV and V were 60 and 92 %, respectively. Positive predictive value and negative predictive value were 74 and 87 %, respectively. Odds ratios for the relationship between hydronephrosis and severe VUR was significant (p = 0.046).

Conclusion: In patients with grade IV or V VUR, hydronephrosis will be observed in the presence of a full bladder. Therefore, a renal ultrasound could be considered a screening test to decide on performing a VCUG.