{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:43:47Z","timestamp":1790959427861,"version":"4.1.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Dokuz Eyl\u00fcl University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Nephrol"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>As voiding cystourethrography is invasive and exposes to radiation and urinary tract infection (UTI), identifying only high-grade reflux is important. We aimed to identify clinical, laboratory and imaging variables associated with high-grade primary reflux in children presenting with UTIs and\/or urinary tract dilatation and develop a prediction model for severe reflux.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data of children who underwent voiding cystourethrography due to UTI and\/or urinary tract dilatation were retrospectively analyzed for demographic, clinical and imaging findings. Patients with severe (grades 4\u20135) reflux were compared with the rest for these parameters and a prediction model was developed for severe reflux.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 1044 patients (574 female). Severe reflux was present in 86 (8.2%) patients. Age\u2009&lt;\u20092\u00a0years, male sex, non-\n                      <jats:italic>E. coli<\/jats:italic>\n                      uropathogens, UTD-P3 dilatation and multiple kidney scars on DMSA scintigraphy were associated with severe reflux. Using these variables a prediction model for severe reflux with a score ranging from 0\u20137 and accuracy rate of 93.4% was developed. A score\u2009\u2265\u20095 had sensitivity 44.2%, specificity 97.4%, PPV 60.3%, NPV 95.1% and OR 29.5 for severe reflux. Scores\u2009\u2265\u20095 and\u2009\u2265\u20094 catch 44% and 73% of severe reflux, while prevent invasive voiding cystourethrography in 94.0% and 83.6% of patients, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Age\u2009&lt;\u20092\u00a0years, male sex, non-\n                      <jats:italic>E. coli<\/jats:italic>\n                      uropathogen growth, presence of UTD-P3 dilatation on ultrasonography and multiple scars on DMSA scintigraphy are risk factors for severe reflux. A scoring system based on these variables appears to be effective in predicting the presence of severe reflux and eliminating unnecessary voiding cystourethrography.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00467-025-06668-7","type":"journal-article","created":{"date-parts":[[2025,1,20]],"date-time":"2025-01-20T18:41:51Z","timestamp":1737398511000},"page":"1975-1982","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Prediction model for severe vesicoureteral reflux in children with urinary tract infection and\/or hydronephrosis"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6955-8542","authenticated-orcid":false,"given":"Pelin","family":"Laleo\u011flu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9513-6661","authenticated-orcid":false,"given":"Gizem","family":"Yildiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3760-7028","authenticated-orcid":false,"given":"Meral Torun","family":"Bayram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1691-1362","authenticated-orcid":false,"given":"Handan G\u00fclery\u00fcz","family":"U\u00e7ar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9959-881X","authenticated-orcid":false,"given":"Salih","family":"Kavukcu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5901-7398","authenticated-orcid":false,"given":"Alper","family":"Soylu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"key":"6668_CR1","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/j.pcl.2006.02.010","volume":"53","author":"LA Greenbaum","year":"2006","unstructured":"Greenbaum LA, Mesrobian HGO (2006) Vesicoureteral Reflux. 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