Correlation not Causation: Looking Back at the History of VUR

Vesicoureteral reflux (VUR) is a medical condition where urine flows retrograde from the bladder superiorly, and has traditionally been considered a risk factor for kidney damage in children. However, over the past decade and a half, several randomized controlled trials have shown the risk of kidney damage in the presence of VUR is low, and any treatment for VUR does not change that risk. Here, we review the history of VUR as a pathologic condition, how the interpretation of that history led to possibly overestimating the danger, and how current findings should be seen in the context of that history.