Primary Vesicoureteral Reflux and Renal Scarring

Pediatr Clin North Am. 2022 Dec;69(6):1115-1129. doi: 10.1016/j.pcl.2022.07.007. Epub 2022 Oct 29.


Vesicoureteral reflux (VUR) is the commonest congenital anomaly of urinary tract in children. It is mostly diagnosed after a urinary tract infection or during evaluation for congenital anomalies of the kidney and urinary tract. High-grade VUR, recurrent pyelonephritis, and delayed initiation of antibiotic treatment are important risk factors for renal scarring. The management of VUR depends on multiple factors and may include surveillance only or antimicrobial prophylaxis; very few patients with VUR need surgical correction. Patients with renal scarring should be monitored for hypertension and those with significant scarring should also be monitored for proteinuria and chronic kidney disease.

Keywords: Antimicrobial prophylaxis; Bladder-bowel dysfunction (BBD); CAKUT; Reflux nephropathy; Renal scarring; Urinary tract infection (UTI); VCUG; Vesicoureteral reflux (VUR).

Publication types

  • Review

MeSH terms

  • Child
  • Cicatrix / complications
  • Cognition
  • Humans
  • Hypertension*
  • Proteinuria
  • Vesico-Ureteral Reflux* / complications
  • Vesico-Ureteral Reflux* / diagnosis
  • Vesico-Ureteral Reflux* / therapy