Reflux Nephropathy

Excerpt

Reflux nephropathy (RN), often presenting in early adulthood with various clinical manifestations of chronic kidney disease, has pathological findings of patchy interstitial scarring, tubular atrophy, and loss of nephron mass. It is often detected during a routine evaluation in early adulthood or during pregnancy. Reflux nephropathy was previously called chronic pyelonephritis as it was believed to result from childhood recurrent urinary tract infections (UTIs). It occurs in approximately 1% to 3% of children and is associated with 7% to 17% of children developing end-stage renal disease (ESRD) across the globe. RN may account for up to 10% of ESRD etiologies in adult patients. In children, RN can be acquired or congenital. Acquired RN is more common among female children and is diagnosed mostly after a febrile UTI. Whereas, the congenital RN is diagnosed antenatally or during hydronephrosis follow-up, with no prior UTI, and is more common in male children.