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Vesicoureteral Reflux in Children

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Pediatric Nephrology

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Abstract

Vesicoureteral reflux (VUR) is the most common congenital anomaly of the urinary tract in children. Primary VUR is diagnosed mostly after a urinary tract infection (UTI). It is also diagnosed during postnatal evaluation of antenatally diagnosed hydronephrosis or other congenital anomalies of the kidney and urinary tract (CAKUT). High-grade VUR (≥ grade 3) is a risk factor for acute pyelonephritis-associated acquired reflux nephropathy. Other important risk factors for reflux nephropathy include recurrent UTIs and a delay in initiation of antibiotic treatment. Not all children with a first febrile UTI need a voiding cystourethrogram (VCUG), but it should be considered in those with abnormal ultrasound findings, recurrent UTIs, and/or an atypical causative pathogen. The management of VUR depends on multiple factors and may include surveillance only or antimicrobial prophylaxis; very few patients with VUR need surgical correction. Patients with reflux nephropathy should be monitored for hypertension and those with significant bilateral scarring should be monitored for proteinuria and chronic kidney disease.

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Authors and Affiliations

  1. Departments of Pediatrics and Urology, Wayne State University School of Medicine, Detroit, MI, USA

    Tej K. Mattoo

  2. Department of Pediatrics and Department of Human Genetics, McGill University, Montreal, QC, Canada

    Indra R. Gupta

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  2. Indra R. Gupta
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Correspondence to Tej K. Mattoo .

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Editors and Affiliations

  1. Division of Nephrology, Bambino Gesù Children’s Hospital –, ROMA, Roma, Italy

    Francesco Emma

  2. Division of Nephrology and Hypertension The Heart Institute, University of Cincinnati Cincinnati Children’s Hospital Medical C, Cincinnati, OH, USA

    Stuart Goldstein

  3. Division of Nephrology, All India Institute of Medical Sciences, Ansari Nagar East, Delhi, India

    Arvind Bagga

  4. Division of Pediatric Nephrology, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA

    Carlton M. Bates

  5. Renal Unit, Graet Ormond Street Hospital, London, UK

    Rukshana Shroff

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Mattoo, T.K., Gupta, I.R. (2021). Vesicoureteral Reflux in Children. In: Emma, F., Goldstein, S., Bagga, A., Bates, C.M., Shroff, R. (eds) Pediatric Nephrology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27843-3_50-2

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  1. Latest

    Vesicoureteral Reflux in Children
    Published:
    04 December 2021

    DOI: https://doi.org/10.1007/978-3-642-27843-3_50-2

  2. Original

    Vesicoureteral Reflux and Renal Scarring in Children
    Published:
    24 December 2014

    DOI: https://doi.org/10.1007/978-3-642-27843-3_50-1

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