genitourinary disorders
Vesicoureteral Reflux and Reflux Nephropathy
Key Points
Consider reflux nephropathy in children<5 years with UTIs or a family history, particularly among boys or if patients have fever or recurrent UTIs. If reflux nephropathy is suspected, do ultrasonography; if abnormal, consider voiding cystourethrography or, to minimize radiation exposure, radionuclide cystography. Consider prophylactic antibiotics and, if reflux is severe, surgical treatment. Consensus is lacking for certain recommendations, such as when and how to image patients for diagnosis and when to prescribe prophylactic antibiotics. Reflux spontaneously resolves in about 80% of young children within 5 years. 