Reflux Nephropathy in Children

Choi, Seung Kang

Abstract

Although an association of the childhood urinary tract infection, vesicoureteral reflux and renal scarring has been recognized for more than 20 years, it is unclear whether renal scar can be caused by vesicoureteral reflux alone, infection alone, or only when both factors are operative. This clinical review with 52 kidneys of vesicoureteral reflux has the aim of evaluation of the role of vesicoureteral reflux and urinary tract infection in the development of the renal scar. In this study, author got the following results: 1. The renal scar was noticed in overall 63.5% among the reflux cases ranging from 25% in Grade I to 100% in Grade V and number and severity proportionated to the grade of the reflux. 2. Urinary tract infection was more commonly present with high grades of the reflux and almost all cases over III were combined with the urinary tract infection. 3. It seemed to be increased potential for development of renal scar in those patients with associated vesicoureteral reflux and urinary tract infection, but author couldn't find out which one influenced more deeply in development of the renal scar. In conclusion, vesicoureteral reflux only may be sufficient to cause the renal scarring, which seems to proportionate to the degree of the reflux, and the combined urinary tract infection which is commonly present also plays an important role in causing the renal scarring.