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Adv Chronic Kidney Dis. 2011 Sep;18(5):348-54. doi: 10.1053/j.ackd.2011.07.006.

Vesicoureteral reflux and reflux nephropathy.

Author information

1
Division of Pediatric Nephrology, Children's Hospital of Michigan, Detroit, USA. tmattoo@med.wayne.edu

Abstract

Primary vesicoureteral reflux (VUR) is the commonest congenital urological abnormality in children, which has been associated with an increased risk of urinary tract infection (UTI) and renal scarring, also called reflux nephropathy (RN). In children, RN is diagnosed mostly after UTI (acquired RN) or during follow-up for antenatally diagnosed hydronephrosis with no prior UTI (congenital RN). The acquired RN is more common in female children, whereas the congenital RN is more common in male children. This observation in children might help explain the differences in the clinical presentation of RN in adults, with males presenting mostly with hypertension, proteinuria, and progressive renal failure as compared with females who present mostly with recurrent UTI and have a better outcome. Known risk factors for RN include the severity of VUR, recurrent UTI, and bladder-bowel dysfunction; younger age and delay in treatment of UTI are believed to be other risk factors. Management of VUR is controversial and includes antimicrobial prophylaxis, surgical intervention, or surveillance only. No evidence-based guidelines exist for appropriate follow-up of patients with RN.

PMID:
21896376
PMCID:
PMC3169795
DOI:
10.1053/j.ackd.2011.07.006
[Indexed for MEDLINE]
Free PMC Article

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