The presentation of congenital versus acquired RN 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 [ncbi.nlm.nih.gov]

Mesangial glomerular lesions can occur in the absence of proteinuria detectable by routine urinalysis, whereas lesions similar to those seen in idiopathic focal sclerosing glomerulopathy were present in the renal biopsies from proteinuric patients. [annals.org]

The American Academy of Pediatrics recommends that children from 2 to 24 months presenting with a UTI should be investigated for VUR. [ citation needed ] References [ edit ] Further reading [ edit ] Wilkins, Lippincott Williams & (2009-01-01). [en.wikipedia.org]

• Back Pain

  Incidence of urinary tract infections, hypertension, proteinuria, back pain and renal calculi. [ncbi.nlm.nih.gov]

• Suggestibility

  Our results suggest that mesangial alterations occur early in the course of reflux nephropathy and may lead to the development of focal sclerosis. [annals.org]

  For reflux nephropathy, the rate of change was significantly associated with age, with a downward trend in incidence with decreasing age suggesting a minor treatment effect. [pediatrics.aappublications.org]

• Albuminuria

  A study of 127 adults (mean age of 41 years) with a diagnosis of VUR in childhood, 35% had unilateral renal scarring, 24% had bilateral renal scarring, 24% had albuminuria, and 11% had hypertension. [ncbi.nlm.nih.gov]

• Microalbuminuria

  Incidence of microalbuminuria in children with pyelonephritic scarring. Pediatric nephrology (Berlin, Germany) 1996; 10 :705–8. [ PubMed ] [ Google Scholar ] 39. Tomlinson PA, Smellie JM, Prescod N, Dalton RN, Chantler C. [ncbi.nlm.nih.gov]

The early 1960s were regarded as the introduction period for the active treatment of childhood vesicoureteric reflux. A time-delay in treatment effect was expected. Patients with ESRD attributable to other causes were used as a comparative group. [pediatrics.aappublications.org]

Diagnosis [ edit ] It is diagnosed by micturating cystography ; scarring can be demonstrated by ultrasound or DMSA. [ medical citation needed ] Treatment [ edit ] The aim of treatment is to reduce renal scarring. [en.wikipedia.org]

In patients with symptomatic VUR, two main treatment modalities include long-term antimicrobial prophylaxis, prompt treatment of UTIs, and surgical correction. [ncbi.nlm.nih.gov]

The severity of the reflux and amount of damage to the kidney help determine treatment. [account.allinahealth.org]

Urinalysis or 24-hour urine studies Urine culture Imaging tests that may be done include: Abdominal CT scan Bladder ultrasound Intravenous pyelogram (IVP) Kidney ultrasound Radionuclide cystogram Retrograde pyelogram Voiding cystourethrogram Outlook (Prognosis [account.allinahealth.org]

Advanced VUR may resemble radiographically polycystic kidney disease or unilateral renal cystic disease, a condition that mimics polycystic kidney disease. [15] Prognosis Advanced age at presentation and bilateral VUR decreases the probability of resolution [ncbi.nlm.nih.gov]

Although ureterovesical reflux in children was described as early as 1897, 1 and the glomerular changes that often ensue if these children survive to adulthood were noted half a century ago, 2 reflux nephropathy—a term embracing both the etiology and [jamanetwork.com]

Etiology The abnormal retrograde flow of urine from the bladder into one or both the ureters leads to vesicoureteral reflux (VUR), which is a direct consequence of incompetent and mislocated ureterovesical valves. [ncbi.nlm.nih.gov]

The review criteria were based on an in-depth search of references conducted on PubMed, using the terms “vesicoureteral reflux”, “children”, “incidence”, “etiology”, “diagnosis”, “treatment” and “outcomes”. [journals.sagepub.com]

Other treatment modalities include surgery (endoscopic injection of collagen behind the intra-vesical ureter, ureteric re-implantation or lengthening of the submucosal ureteric tunnel) which has its protagonists. [ medical citation needed ] Epidemiology [en.wikipedia.org]

Epidemiology The exact incidence and prevalence of RN are not known. It is primarily a disorder of childhood or early adulthood and is more common in females than males. [ncbi.nlm.nih.gov]

Reflux nephropathy is a direct consequence of VUR or other urologic congenital anomalies stemming from chronic high-pressure sterile urine reflux and often leads to recurrent urinary tract infections (UTIs) in the early childhood. [3] Pathophysiology [en.wikipedia.org]

Pathophysiology VUR leads to high-pressure sterile urine reflux which stunts the normal growth of the kidneys and often exacerbated by the recurrent childhood infections. [ncbi.nlm.nih.gov]

New developments on the knowledge of pathophysiology of renal damage associated to reflux opened the way towards a different diagnostic work-up and different therapeutic approaches. [journals.sagepub.com]

Quickly treating conditions that cause reflux of urine into the kidney may prevent reflux nephropathy. [account.allinahealth.org]

Nuclear cystography can be used to prevent radiation exposure in patients with post-surgical VUR follow up. [ncbi.nlm.nih.gov]

It is believed that end-stage renal disease (ESRD) attributable to reflux nephropathy is preventable by the active treatment of vesicoureteric reflux in childhood with long-term antibiotics and ureteric reimplantation surgery. [pediatrics.aappublications.org]

Pennesi, M Travan, L Peratoner, L Is antibiotic prophylaxis in children with vesicoureteral reflux effective in preventing pyelonephritis and renal scars? A randomized, controlled trial. Pediatrics 2008 ; 121: e1489 – e1494. [journals.sagepub.com]