Vesicoureteral reflux and reflux nephropathy in children

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S L Schulman1, H M Snyder

  • 1Division of Pediatric Nephrology, Children's Hospital of Philadelphia, PA 19104.

Current Opinion in Pediatrics
|April 1, 1993
PubMed

Insights

Vesicoureteral reflux (VUR) affects many children with urinary tract infections and can lead to kidney damage. Identifying at-risk children through noninvasive studies is crucial for early intervention.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Pediatric Urology

Background:

  • Vesicoureteral reflux (VUR) is a significant factor in pediatric urinary tract infections (UTIs).
  • Reflux nephropathy is a leading potentially reversible cause of end-stage renal disease in children and adults.
  • The pathogenesis of reflux nephropathy requires further elucidation despite extensive research.

Purpose of the Study:

  • To highlight the diagnostic challenges in reflux nephropathy.
  • To emphasize the need for identifying children with dysfunctional voiding.
  • To advocate for the use of noninvasive studies in at-risk pediatric populations.

Main Methods:

  • Review of existing literature on VUR and reflux nephropathy.
  • Analysis of findings from the International Reflux Study in Children (1992).
  • Discussion of diagnostic approaches for identifying children at risk.

Main Results:

  • The 1992 International Reflux Study showed no clear advantage for surgical versus medical management in high-grade VUR over 5 years.
  • Newer surgical techniques may offer improved outcomes.
  • Dysfunctional voiding remains a critical area for identification in children with VUR.

Conclusions:

  • Early identification of children at risk for VUR and its complications is essential.
  • Noninvasive diagnostic studies are recommended for children with antenatally diagnosed hydronephrosis and siblings of those with known VUR.
  • Further research into the pathogenesis and optimal management of reflux nephropathy is warranted.

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