Reflux nephropathy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Reflux nephropathy, RN is a term applied when small and scarred kidneys (chronic pyelonephritis, CPN) are associated with vesico-ureteric reflux (VUR). CPN being the commonest cause, there are other causes including analgesic nephropathy and obstructive injury. Scarring is essential in developing RN and occurs almost during the first five years of life. The end results of RN are hypertension, proteinuria, CRF and eventually ESRD, end stage renal disease.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Urine flows from each kidney through tubes called ureters and into the bladder. When the bladder is full, it squeezes and sends the urine out through the urethra. None of the urine should flow back into the ureter when the bladder is squeezing. Each ureter has a one-way valve where it enters the bladder that prevents urine from flowing back up the ureter.

But in some people, urine flows back up to the kidney. This is called vesicoureteral reflux.

Over time, the kidneys may be damaged or scarred by this reflux. This is called reflux nephropathy

Reflux can occur in people whose ureters do not attach properly to the bladder or whose valves do not work well. Children may be born with this problem or may have other birth defects of the urinary system that cause reflux nephropathy.

Reflux nephropathy can occur with other conditions that lead to a blockage of urine flow, including:

• Bladder outlet obstruction, such as an enlarged prostate in men
• Bladder stones
• Neurogenic bladder, which can occur in people with multiple sclerosis, spinal cord injury, or other nervous system (neurological) conditions

Reflux nephropathy also can occur from swelling of the ureters after a kidney transplant or from injury to the ureter.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

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There is a genetic predisposition, first-degree relatives have a great increase in the chance of VUR.

The gene frequency is estimated to be 1:600. All children with UTI should be investigated for VUR.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

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Risk factors for reflux nephropathy include:

• Abnormalities of the urinary tract
• Personal or family history of vesicoureteral reflux
• Repeat urinary tract infections

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Please help WikiDoc by adding more content here. It’s easy! Click here to learn about editing.

The end results of RN are

• Hypertension
• Proteinuria
• Chronic Renal Failure
• ESRD (end stage renal disease)
• Blockage of the ureter after surgery
• Chronic or repeat urinary tract infections
• Kidney infection
• Nephrotic syndrome
• Persistent reflux
• Scarring of the kidneys

The outcome varies, depending on the severity of the reflux. Some people with reflux nephropathy will not lose kidney function over time, even though their kidneys are damaged. However, kidney damage may be permanent. If only one kidney is involved, the other kidney should keep working normally.

Reflux nephropathy may cause kidney failure in both children and adults.

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