Vesicoureteral reflux is associated with increased risk of chronic kidney disease: A nationwide cohort study

Abstract

The association between vesicoureteral reflux (VUR) and chronic kidney disease (CKD) risk remains unestablished. We investigated the incidence of CKD in children with VUR in Taiwan and evaluated whether they had a higher risk of CKD than the general population. A nationwide population-based cohort study was conducted among children with VUR identified using Taiwan's National Health Insurance Research Database from 2000 to 2013. VUR was defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes. We identified the children with VUR and randomly selected comparison children according to a 1:1 ratio, matching them by age, gender, index year and comorbidity using data from the National Health Insurance Research Database. In total, 8648 children with VUR and 8648 comparison children were included. All children were followed from the study date until a diagnosis of CKD, termination of insurance, or the end of 2013. Cox proportional hazards regressions were performed to compare the hazard ratios for CKD between the 2 cohorts. Incident cases of CKD were identified. After adjustment for potential confounders, the study cohort was independently associated with a higher risk of CKD (adjusted hazard ratio, 3.78; 95% confidence interval, 2.10-7.18). This population-based cohort study indicated that children with VUR have a higher risk of CKD than those without VUR.