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Vesicoureteral Reflux Index (VURx) of Kirsch et al

Description

Kirsch et al reported the Vesicoureteral reflux index (VURx) for infants with vesicoureteral reflux. This can help to identify a child who may require more aggressive management. The authors are from Children’s Healthcare of Atlanta and Emory University.


 

Patient selection: vesicoureteral reflux diagnosed in a child less than 2 years of age

 

Parameters:

(1) gender

(2) reflux timing

(3) ureteral anomaly

(4) vesicoureteral reflux grade

 

Parameter

Finding

Points

gender

male

0

 

female

1

reflux timing

early to mid filling

3

 

late filling

2

 

voiding

1

ureteral anomaly

periureteral diverticulum

1

 

complete duplication

1

 

neither

0

reflux grade

Grade 1, 2 or 3

0

 

Grade 4 or 5

1

 

index =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum index: 1

• maximum index: 6

• A child with an index of 1 had an 88% chance of spontaneous resolution during 2 year followup versus 14% if index 5 or 6 (Arlen et al)..

 

Index

Spontaneous Resolution or Improvement within 2 Years

1

88%

2

70-80%

3

50-60%

4

20-30%

5 or 6

14%

 


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