U.S. News & World Report: A Patient’s Guide To Kidney Reflux

By Heidi Godman

The flow of urine through the body is supposed to move in one direction only, starting at the kidneys and moving south through the rest of the urinary tract. But sometimes urine flow reverses and backs up to the kidneys. This reflux into the kidneys – technically known as vesicoureteral reflux or VUR – can be diagnosed at any age, but is typically caught in our earliest years. Research suggests that about 2% of all girls and 0.6% of all boys have kidney reflux.

Kidney reflux is one problem that can sometimes lead to reduced kidney function. Kidney reflux is classified into two categories.

No matter what causes kidney reflux, it can occur on just one side of the urinary tract (involving one ureter and one kidney) or on both sides of the urinary tract (involving both kidneys and both ureters).

Complications

The issue of kidney reflux isn’t the act of the urine yo-yoing up and down between the kidneys and the bladder; that part is painless, and most people don’t know that the reflux is occurring. The problem is that kidney reflux makes it easier for bacteria to grow in the urinary tract, greatly increasing the risk for repeat urinary tract infections. A lower urinary tract infection can involve the bladder and urethra; an upper urinary tract infection can involve the ureters and kidneys.

“In a normal adult or child, a (lower) urinary tract infection is pretty benign. But if the infected urine refluxes up into the kidney, you can develop a kidney infection, which is a lot more serious,” says Dr. Nathan Beins, a pediatric nephrologist at Children’s Mercy Kansas City in Missouri.

Kidney infections have two main risks:

• Scarring and decreased kidney function. “One little area might get scarred with the first infection and increase the risk for chronic kidney disease. After two infections or more, you might have changes in kidney function that will last the rest of your life,” Beins says. “We don’t know how many infections you have to get before you could develop kidney scarring.”
• Sepsis. When bacteria from a kidney infection (or any infection) leaks into the blood, the body fights back by releasing chemicals into the blood. But the chemicals can cause a chain reaction that lead to tissue damage, organ failure and death.

For many children, simply growing and getting bigger is enough to resolve kidney reflux. “If you have low-grade reflux, 80% of kids outgrow it. If it’s higher-grade reflux, it’s around 20% to 40% who outgrow it,” Beins says.

Read the full story via U.S. News & World Report

Learn more about Nephrology at Children's Mercy