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Vesicoureteral reflux is it important to find?

  • Pro/Con Debate
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Abstract

Vesico-ureteral reflux (VUR) has long been recognized as associated with urinary tract infections (UTIs), renal scarring, and chronic kidney disease (CKD). The concept of “reflux nephropathy” was born, whereby the VUR was considered the culprit, predisposing to recurrent UTIs and providing a conduit whereby the infection could ascend to the kidneys resulting in scarring and destruction. The more severe grades of reflux were thought to place the young child at particular risk of CKD. The question being asked in this pro/con debate is whether VUR is indeed the culprit responsible for a significant proportion of children with CKD, a number of whom progress to end-stage kidney failure (ESKF), and is thus important to find and treat, or is it an innocent bystander associated with CKD and ESKF but not the cause. We believe the latter and will present convincing evidence supported by large scale prospective randomized controlled trials that VUR is not the ogre it was thought to be and is not important to find following a UTI (with some exceptions).

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Perth Children’s Hospital, Perth, Australia

    Ian Hewitt

  2. Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione Ca’ Granda IRCCS, Policlinico di Milano, Milan, Italy

    Giovanni Montini

  3. Giuliana and Bernardo Caprotti Chair of Pediatrics, Department of Clinical Sciences and Community Health, University of Milano, Milan, Italy

    Giovanni Montini

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  1. Ian Hewitt
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  2. Giovanni Montini
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Correspondence to Giovanni Montini.

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Hewitt, I., Montini, G. Vesicoureteral reflux is it important to find?. Pediatr Nephrol 36, 1011–1017 (2021). https://doi.org/10.1007/s00467-020-04573-9

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  • DOI: https://doi.org/10.1007/s00467-020-04573-9

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