In children, particularly those in the first six years of life, urinary infection can cause kidney damage. Injury to the kidney may result in a small area of scarring, loss of future growth potential, or widespread scarring and atrophy. Even a small area of scarring in one kidney may be a cause of high blood pressure later in life. Untreated reflux on both sides can, in the most severe instances, result in kidney failure requiring dialysis or transplantation. Because reflux resluts in incomplete emptying of the urinary tract, infection may be encouraged.
Some patients are also susceptible to kidney stone formation because of their reflux.
Evaluation of Reflux Our baseline evaluation of vesicoureteral reflux consists of an upper tract study and a lower tract study. For most children, upper tracts can be adequately evaluated by ultrasound. Reflux is evaluated by a voiding cystogram and this generally requires a catheter passed into the bladder to fill it with an imaging substance. We give the patient a short course of antibiotics to cover this procedure if none are otherwise being taken. Minimal x-ray exposure is involved and the testicles are protected in boys.