RENAL TUBULAR-ACIDOSIS IN CHILDREN WITH VESICOURETERAL REFLUX

Purpose: We evaluated renal tubular acidosis in children with primary vesicoureteral reflux. Materials and Methods: We studied 18 children 4 to 15 years old to determine age at onset, reflux intensity, and rena l scars and volume as possible associated factors of renal tubular aci dosis. Patients had normal glomerular filtration rates and no urinary infections for the last 12 weeks, and they had not undergone urologica l surgery. Urine acidification and alkalization tests were done, and t he Mann-Whitney U test was used to assess differences between the grou ps with and without renal tubular acidosis. Results: A total of 14 pat ients had unilateral and 4 had bilateral reflux, which varied in sever ity. All children except 2 had renal scarring. Bilateral renal volume was smaller in the renal tubular acidosis group. Nine patients had dis tal renal tubular acidosis, including 4 with short stature. Conclusion s: Several patients with vesicoureteral reflux had renal tubular acido sis and some had growth failure. Grades of reflux and renal scarring w ere similar in patients with and without renal tubular acidosis. A sin gle evaluation of reflux is of slight value for predicting future func tional tubular impairment, and the duration of reflux and other associ ated factors may be more important. Renal tubular acidosis was the mai n explanation for growth failure in these patients.