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Advances in Urology
Volume 2008, Article ID 508949, 7 pages
http://dx.doi.org/10.1155/2008/508949
Review Article

Vesicoureteral Reflux, Reflux Nephropathy, and End-Stage Renal Disease

Division of Pediatric Nephrology, Department of Pediatrics, University of California, San Francisco, CA 94143-0532, USA

Received 28 February 2008; Accepted 12 June 2008

Academic Editor: Hiep Nguyen

Copyright © 2008 Paul Brakeman. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To review the contribution of vesicoureteral reflux and reflux nephropathy to end-stage renal disease. Data Source. Published research articles and publicly available registries. Results. Vesicoureteral reflux (VUR) is commonly identified in pediatric patients and can be associated with reflux nephropathy (RN), chronic kidney disease (CKD), and rarely end-stage renal disease (ESRD). Patients with reduced GFR, bilateral disease, grade V VUR, proteinuria, and hypertension are more likely to progress to CKD and ESRD. Because progression to ESRD is rare in VUR and often requires many decades to develop, there are limited prospective, randomized, controlled trials available to direct therapy to prevent progression to ESRD. Conclusions. Identification of patients with increased risk of progression to CKD and ESRD should be the goal of clinical, biochemical, and radiological evaluation of patients with VUR. Treatment of patients with VUR should be directed at preventing new renal injury and preserving renal function.