Text Box: FACTORS ASSOCIATED WITH RENAL SCAR IN CHILDREN WITH VESICOURETERAL REFLUX Kim K-H, Jang S-H, Sim H-S, Lee D-Y Dept. of Pediatrics, Chonbuk National University, Chonju, Korea Objective: The purpose of this study was to evaluate the risk factors associated pyelonephritic renal scarring such as age, gender, grade of vesicoureteral reflux (VUR) and angiotensin-converting enzyme (ACE) gene polymorphism in the patients with and without renal scar associated with VUR. Methods: During the period from January 1994 to July 2000, we had 93 children with urinary tract infection associated with VUR. The patients were divided into two groups according to follow up 99mTc-2,3-dimercaptosuccinic acid renal scan. We analyzed and compared the factors associated with renal scarring between the two groups. Results: There was no significant difference in gender, causative organism, ACE gene polymorphism, height and weight at diagnosis between renal scar group and non-scar group. The age at diagnosis was significantly higher in renal scar group than in non-scar group. Infants below 1 year of age with VUR were at higher risk of having renal scar than those above 1 year of age. The frequency of renal scarring is related to the severity of VUR. Conclusion: Low age, especially below 1 year of age, and severe VUR were the significant risk factors for acute pyelonephritis and subsequent renal scarring. However the other factors such as gender, causative organism and ACE gene polymorphism were not associated with renal scarring. Therefore, renal scarring can be decreased or prevented by early detection and treatment of acute pyelonephritis and VUR. 2323