- On September 26, 2017 /
- By davita /
- In Health Tips
What is Reflux Nephropathy?
Reflux means that something goes back the way it has come, instead of travelling onwards. In reflux nephropathy, this means that urine passes back up from the bladder towards the kidneys, instead of coming out of the body (click here for a picture of the bladder, kidneys and drainage tubes). Nephropathy is a medical term for kidney disease.
Reflux nephropathy is sometimes also called just reflux, and an older name for the same condition is chronic pyelonephritis, or chronic pyelonephritis with reflux. It is sometimes also called vesico-ureteric reflux. Vesico-ureteric means from the bladder to the ureter (the tube from bladder to kidney).
What causes reflux nephropathy?
Nearly all cases of reflux are caused by an abnormality that develops before birth. One or both of the drainage tube from the kidneys to the bladder (called ureters) enter the bladder at the wrong angle. When the bladder contracts to pass urine outwards, the ureter is not pinched off, and instead of all the urine being passed out of the body, some goes back up the ureters towards the kidneys.
How is reflux suspected?
Children or adults may have frequent or severe urine infections – though these are common. Vesico-ureteral reflux (VUR) can be found, during investigations for protein in urine (Protinurea), kidney stones or renal failure. VUR is sometimes symptom-free, only being discovered because another family member has been diagnosed.
Reflux is the abnormal passage of urine back up the ureter and may occur on one or both sides. It is managed by the urologist primarily. Reflux may be primary or secondary and its importance lies in the fact that when it is associated with a urinary tract infection (UTI) there is potential for pyelonephritis and renal scarring. The scarring may lead to hypertension, proteinuria and possible renal failure (reflux nephropathy).
Treatment plans are individualized according to age/sex, grade of reflux, associated urologic problems, presence of scarring, hypertension, proteinuria, and patient/parent compliance.
In general, patients with reflux are treated initially with surveillance and prophylactic antibiotics, as in many the reflux will resolve spontaneously without the need for surgery. Patients with urge incontinence will also need to take bladder antispasmodics.
Since any mistakes in diagnosing reflux nephropathy can ultimately lead following complications:
Kidney (renal) scarring. Untreated UTIs can lead to scarring, also known as reflux nephropathy, which is permanent damage to kidney tissue. A backup of urine exposes the kidneys to higher than normal pressure.
If your kidneys are infected, this can lead to scarring over time. Extensive scarring may lead to high blood pressure and kidney failure.
High blood pressure (hypertension). Because the kidneys remove waste from the bloodstream, damage to your kidneys and the resultant buildup of wastes can raise your blood pressure.
Kidney failure. Scarring can cause a loss of function in the filtering part of the kidney. This may lead to kidney failure, which can occur quickly (acute) or may develop over time (chronic).
So choosing the best urologist is very important to avoid these further complications.