​Reflux Nephropathy

Reflux nephropathy, also called vesicoureteral reflux (VUR), is the abnormal flow of urine from the bladder back up the ureters (tubes that connect the kidneys to the bladder) into the kidneys, causing kidney damage and scarring. Normally, urine flows from the kidneys, through the ureters, into the bladder. Each ureter has a one-way flap that stops the urine from flowing back up the ureter. There are two type of reflux nephropathy:

  • Primary reflux nephropathy occurs due to a defect in the one-way flap (which ensures unidirectional flow of urine) present at birth (congenital). Primary reflux nephropathy often resolves on its own as your child grows. This is the most common type of reflux nephropathy

  • Secondary reflux nephropathy occurs due to a blockage in the bladder or urethra which forces the urine to flow backwards into the kidney. It can be caused by surgery, injury or a past infection. Though it can occur at any age, it is more common in children who have other birth defects such as spina bifida (a birth defect in which bones of the spine fail to form properly around the spinal cord)

This disease is more prevalent in girls and in children with a family history of reflux nephropathy. White children are more susceptible to this disease as compared to black children.

Reflux nephropathy may not show any symptoms. 

Urinary tract infection (UTI) is a common symptom in children with reflux nephropathy. Symptoms of UTI include:

  • Fever

  • Pain or burning while urinating

  • Frequent urge to urinate

  • Feeling that the bladder isn’t emptied completely

  • Blood in urine

UTI in infants may exhibit certain symptoms including:

  • Fever without a cause

  • Diarrhoea

  • Lack of appetite

  • Irritability

As your child grows, reflux nephropathy may exhibit certain symptoms, including:

  • Bedwetting

  • High blood pressure

  • Foamy urine due to presence of protein

  • Kidney failure                         ​

Visit our highly professional doctors at the Children's Hospital Service Line at The Aga Khan University Hospital the only internationally accredited hospital in Pakistan, if you notice any of the above mentioned symptoms in your child.                         
Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.                         

Reflux nephropathy is usually diagnosed when your child shows symptoms of urinary tract infection (UTI). Initially, the doctor may perform a physical exam and inquire about your child’s symptoms.

Urinalysis is usually done to confirm the presence of UTI in your child. You may be asked to collect your child’s urine samples over the period of twenty-four hours for a precise result.

Further testing may be carried out to confirm reflux nephropathy. These include:

  • Kidney and bladder ultrasound, in which sound waves and a sensor is used to create an image on the computer to be studied by the doctor. Sound waves are sent by a handheld device that is moved across the abdomen

  • VCUG (Voiding cystourethrogram) in which a catheter (hollow tube) is placed in the urethra and a liquid dye is injected in the bladder. X-ray images are taken as the bladder fills and drains. These images determine if there is any reverse flow of the urine into the ureters and kidneys

  • Nuclear scan detects the tracer and shows whether the urinary tract is working properly                          ​

At the Children's Hospital Services at The Aga Khan University Hospital our doctors are committed to providing quality healthcare. While the diagnose of reflux nephropathy can be a cause of concern, be rest assured that your child is in good hands and well cared for.

Treatment options depend on the severity of the disease. If your child has a mild case of reflux nephropathy, they may not require any treatment at all as the disease will resolve on its own with age. Treatments available for more severe cases include:

  • Medications to treat or prevent infections. Your child will have to be closely monitored, with regular physical exams and urine tests, while they complete the antibiotics course

  • Surgery, if your child does not respond to medications, to repair the defected one-way flaps between the bladder and the ureters.                         ​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.                         ​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.                         

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.