Abstract: TH-PO1197
Clinical Predictors of Active Intervention in Children with Vesicoureteral Reflux
Session Information
- Pediatric Nephrology: CV Health, CKD, AKI, Dialysis, Transplantation, and Health Services Research
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1800 Pediatric Nephrology
Author
- Suh, Jin-Soon, The Catholic University of Korea College of Medicine, Seocho-gu, Korea (the Republic of)
Background
Management of vesicoureteral reflux (VUR) in children ranges from observation to continuous antibiotic prophylaxis (CAP) or surgical correction. Identifying factors that influence the decision to initiate active intervention is important for optimizing patient management. This study aimed to determine clinical predictors associated with intervention in pediatric VUR.
Methods
We retrospectively reviewed 358 children diagnosed with VUR. After excluding cases with inconsistent follow-up data, 329 patients were included in the final analysis. The primary outcome was active intervention, defined as initiation of CAP or surgical correction. UTI episodes were categorized as ≤2 versus ≥3. Multivariable logistic regression analysis was performed adjusting for age, sex, prenatal ultrasonographic abnormalities, DMSA-confirmed acute pyelonephritis (APN), extended-spectrum beta-lactamase (ESBL) positivity, and year of diagnosis.
Results
Among 329 children, 221 (67%) underwent active intervention. Children with ≥3 UTI episodes had a significantly higher likelihood of intervention compared with those with ≤2 episodes. In multivariable analysis, recurrent UTI (≥3 episodes) was the strongest independent predictor of intervention (adjusted OR 3.12; 95% CI 1.92–5.08; p<0.001) (Table). Increasing age was modestly associated with intervention. Neither ESBL positivity nor DMSA-confirmed APN independently predicted intervention. A trend toward decreased intervention in more recent years was observed.
Conclusion
In pediatric VUR, recurrent infection burden was the strongest determinant of active intervention. Clinical decision-making appeared to be driven primarily by infection recurrence rather than antimicrobial resistance or imaging findings.
Acknowledgment
None