Vesicoureteral reflux (VUR) basically is the backflow of urine from the bladder up into the upper urinary tract, which includes the ureters and the kidneys. Often, it can be asymptomatic, especially early on in the course of the condition. Down the road however, numerous consequences can arise which can cause serious burden to the patient.
Urinary Tract Infection
This is the most common complication of VUR and symptoms include frequent urination, burning urination, fever and blood in the urine. If the UTI/VUR go untreated, future complications for children include protein present in the urine, frequent bed wetting and premature kidney failure.
Pyelonephritis
This describes infection of the kidney and is a major consequence of VUR. The mechanism behind it is that the bacteria in the bladder can travel upwards back into the kidney and cause infection. The patient will have pain in the flanks, chills, very high fever and systemic signs like fatigue. This can result in scarring of the kidney and deficits in function. This has many consequences such as end stage renal disease necessitating dialysis, impaired growth and increased complications during future pregnancy.
Hypertension
VUR is one of the most common causes of hypertension in children and can contribute to hypertension later on in life as well. Damage to the kidney, such as from infection, can result in activation of the hormone known as renin. Its effects include reabsorption of fluid and sodium and as a result of the increased fluid in the system, increased blood pressure can result.
Acute Kidney Failure
If the damage to the kidney affects the filtration component, the wastes that are normally filtered end up accumulating in the blood stream and are quite toxic. This can necessitate emergency dialysis while your kidney attempts to heal and recuperate.
Chronic Kidney Failure
This is the most serious manifestation of kidney disease and represents irreversible loss of kidney function, usually over the long term. Once function reaches and goes below 15 percent of normal function, the patient will need regular dialysis or a transplant to survive.
References
- Vesicoureteral Reflux: by Caleb Nelson, MD and Harry Koo, MD
- "Nelson Textbook of Pediatrics, 18th Edition;" Kliegman; 2007
- "Campbell-Walsh Urology, 9th Edition;" Wein; 2007
