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Related Experiment Videos

Renal functional changes associated with vesicoureteral reflux.

R D Walker1

  • 1Department of Surgery, University of Florida College of Medicine, Gainesville.

The Urologic Clinics of North America
|May 1, 1990
PubMed
Summary

Reflux commonly causes kidney dysfunction, starting with tubular issues and progressing to glomerular damage. Acid-base imbalances may impact bone growth, and pyelonephritis worsens kidney damage, especially in scarred kidneys.

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Area of Science:

  • Nephrology
  • Pediatric Nephrology
  • Renal Physiology

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children.
  • Reflux can lead to kidney damage and dysfunction.
  • Early detection and management of VUR are crucial to prevent long-term sequelae.

Purpose of the Study:

  • To investigate the spectrum of renal functional abnormalities associated with VUR.
  • To determine the early and late manifestations of renal dysfunction in VUR patients.
  • To assess the clinical relevance of acid-base balance abnormalities in VUR.

Main Methods:

  • Review of existing data on renal function in patients with VUR.
  • Analysis of tubular and glomerular function tests.
  • Evaluation of acid-base balance studies and fractional excretion measurements.

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  • Correlation of renal function with pyelonephritis and renal scarring.

    • Main Results:

    • Renal functional abnormalities are frequently observed in patients with VUR.
    • Tubular dysfunction, particularly concentrating defects, appears early.
    • Glomerular dysfunction is a later manifestation of VUR-associated kidney damage.
    • Acid-base balance abnormalities, though uncommonly studied, may have significant clinical implications for bone growth.
    • Fractional excretion studies are less sensitive than concentrating ability in detecting renal dysfunction.
    • Concurrent pyelonephritis accelerates renal damage and exacerbates existing functional abnormalities.
    • Renal scarring is associated with more prevalent functional abnormalities and may predict subclinical renal processes.

    Conclusions:

    • Vesicoureteral reflux is strongly linked to diverse renal functional abnormalities.
    • Early tubular dysfunction is a hallmark of reflux nephropathy.
    • Acid-base disturbances warrant further clinical investigation due to potential impact on growth.
    • Monitoring renal function, especially in the presence of scarring or pyelonephritis, is essential for managing VUR patients.