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Pediatric Nephrology

, Volume 7, Issue 4, pp 365–369 | Cite as

Reflux nephropathy: the glomerular lesion and progression of renal failure

  • Gavin J. Becker
  • Priscilla Kincaid-Smith
Original Article

Abstract

Reflux nephropathy is the cause of 5%–10% of dialysed end-stage renal failure. Once scarring has occurred, the prognosis depends on the severity of initial damage and the presence of proteinuria, which reflects the development of glomerulosclerosis. It is independent of ongoing reflux or infection. Histological appearances highly suggestive of reflux nephropathy can occur in radiologically normal kidneys. Duplex Doppler scans of ureteric orifices suggest these patients may have lateral insertion, suggesting past reflux. Glomerular hypertrophy correlates well with reduced renal function and severe renal scarring, but poorly with focal and segmental glomerulosclerosis, which correlates with proteinuria. Increasing attention is being paid to the tubulointerstitium and the relationships between the cellular infiltrates (mainly T4 cells) and glomerular, tubular and vascular damage. Control of hypertension, hyperphosphataemia and a low-protein diet are the only currently widely accepted treatments for slowing progression.

Key words

Reflux nephropathy Focal glomerulasclerosis Renal failure Morphometrics Low-protein diet 

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Copyright information

© IPNA 1993

Authors and Affiliations

  • Gavin J. Becker
    • 1
  • Priscilla Kincaid-Smith
    • 1
  1. 1.Department of NephrologyThe Royal Melbourne HospitalVictoriaAustralia

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