Vesicoureteral reflux and renal scarring in children

摘要: Vesicoureteral reflux (VUR) is the most common congenital anomaly of urinary tract. The gold standard for diagnosing VUR a voiding cystourethrogram (VCUG). According to International Reflux Grading Scheme, severity classified as grade I–V. It diagnosed in 30–40 % children with tract infection (UTI). may be an isolated abnormality (primary VUR) or it occur association other anomalies kidney and (CAKUT), including renal dysplasia obstructive uropathy. VURmay also noted secondary bladder dysfunction such neurogenic (e.g., posterior urethral valves) (secondary VUR). An increasing number are being during follow-up antenatally abnormalities no preexisting history UTI. Renal scarring associated called nephropathy (RN). RN categorized “congenital,” which result abnormal development leading focal dysplasia, “acquired” pyelonephritis-induced injury. Complications pediatric patients include proteinuria, hypertension, end-stage failure (ESRF). management has been driven by belief that risk UTIassociated injury decreased long-term antimicrobial prophylaxis surgical correction VUR. Over years, many studies have assessed if one treatment modality superior another preventing injury, concluding outcome intervention better than other. Recently, surveillance intervention, particularly low-grade VUR, proposed option, generated questions on usefulness routinely after UTI, clinical presentation typical ultrasound normal. This argument forms basis various recent recommendations first