Reflux nephropathy

Alternative names:

chronic atrophic pyelonephritis; nephropathy - reflux; ureteral reflux; vesico-ureteric reflux

Treatment:

Simple, uncomplicated reflux (called primary reflux) less than Grade III may be treated by:

• careful watching
• repeated urine cultures
• antibiotics to prevent infection
• annual ultrasound of kidneys to follow development

More severe reflux may require surgery. This can include:

• ureteral reimplantation
• reconstructive repair

Expectations (prognosis):

The outcome varies. Most cases of vesicoureteric reflux resolve spontaneously. However, the damage to the kidney may be permanent. If only one kidney is involved, the other kidney may continue to function adequately.

Reflux nephropathy may cause as many as 20% of the cases of renal failure in children and young adults.

Complications:

• permanent damage to one or both kidneys
• chronic renal failure if both kidneys are involved
  • progressing to end-stage renal disease

• chronic or recurrent urinary tract infection
• nephrotic syndrome
• hypertension
• pyelonephritis
• renal scarring
• persistent reflux
• obstruction of the ureter following surgery

Calling your health care provider:

Call your health care provider if symptoms indicate reflux nephropathy may be present.

Call your health care provider if decreased urine output or other new symptoms develop.