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Pediatric Nephrology

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01-05-2015 | Editorial Commentary

The RIVUR study: a review of its findings

Authors: Gabriel Cara-Fuentes, Nirupama Gupta, Eduardo H. Garin

Published in: Pediatric Nephrology | Issue 5/2015

Abstract

Background

The conclusion drawn by the authors of the Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trial is that antimicrobial prophylaxis reduces the risk of recurrent urinary tract infection (UTI)—but not of renal scarring—in patients with vesicoureteral reflux (VUR).

Results

A review of the findings showed that the decreased recurrent UTI rate was only present at the end of the 2-year follow-up period and was only slightly increased (12.3 %) above the 10 % cutoff for statistical significance. The difference was not observed in children younger than two years of age with VUR grade III and IV. In addition, the rate of new renal scarring was not statistically different between the prophylaxis and placebo groups (8.2 vs. 8.4 %, respectively). A high rate of uropathogen antibiotic resistance was observed in the prophylaxis group (68.4 vs. 24.6 %, respectively).

Conclusion

The analysis of the RIVUR findings questions the validity of its authors suggestion that the results may warrant reconsideration of the current recommendations by the American Academy of Pediatrics on obtaining a voiding cystourethrogram after the first febrile UTI and the use of urinary antibiotic prophylaxis in VUR patients.

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Title: The RIVUR study: a review of its findings
Authors: Gabriel Cara-Fuentes
Nirupama Gupta
Eduardo H. Garin
Publication date: 01-05-2015
Publisher: Springer Berlin Heidelberg
Published in: Pediatric Nephrology / Issue 5/2015
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI: https://doi.org/10.1007/s00467-014-3021-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The RIVUR study: a review of its findings

Abstract

Background

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Results

Conclusion

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