What Is Reflux Nephropathy?

Reflux Nephropathy is a chronic kidney condition that occurs when urine flows backward from the bladder into the kidneys, leading to kidney damage. This backward flow, known as vesicoureteral reflux (VUR), can cause repeated urinary tract infections (UTIs) and scarring of the kidney tissue over time.

What Causes Reflux Nephropathy?

• Primary VUR: A congenital defect in the valve between the bladder and ureters
• Secondary VUR: Caused by bladder dysfunction due to obstruction or nerve problems
• Repeated urinary tract infections, especially in children
• Incomplete emptying of the bladder
• Family history of VUR or kidney disease

What Are the Symptoms of Reflux Nephropathy?

• Recurrent UTIs, especially in young children
• Fever, painful urination, or foul-smelling urine
• High blood pressure
• Protein in the urine (proteinuria)
• Poor growth in children
• Signs of kidney dysfunction in advanced cases (fatigue, swelling, etc.)
• Often silent in early stages and discovered during evaluation for UTIs

How Is Reflux Nephropathy Diagnosed?

• Urinalysis and urine culture to detect infections or protein
• Renal ultrasound to assess kidney structure and detect scarring
• Voiding cystourethrogram (VCUG) to visualize urine reflux during urination
• DMSA scan to assess kidney function and identify scarring
• Blood tests to evaluate kidney function (creatinine, BUN)

What Are the Treatment Options for Reflux Nephropathy?

• Antibiotic prophylaxis to prevent UTIs in mild cases
• Surgical correction (ureteral reimplantation) for severe or unresponsive VUR
• Treatment of bladder dysfunction if present
• Blood pressure management with antihypertensive medications
• Monitoring kidney function regularly to detect early signs of decline
• Lifelong follow-up may be required depending on severity

Can Reflux Nephropathy Cause Complications?

• Chronic kidney disease or end-stage renal failure
• Hypertension
• Permanent kidney scarring
• Increased risk of future kidney infections
• Pregnancy complications in females with kidney damage

How Can Reflux Nephropathy Be Prevented?

• Prompt treatment of urinary tract infections
• Regular follow-up and imaging in children with known VUR
• Screening of siblings if one child is diagnosed with VUR
• Educating families about symptoms of UTIs and seeking timely medical care