What is Kidney Reflux? Symptoms, Diagnosis and Treatment Methods

Dr. Statement about kidney reflux from Associate Professor Çağdaş Gökhun Özmerimanı. It is the urine stored in the urinary bladder (bladder) escaping backwards towards the urinary ducts (ureters) and kidney. This situation facilitates the access of bacteria to the kidney, leading to infections that may result in loss of function in the kidney, and enlargement of the urinary tract and kidney (hydronephrosis). The incidence in children is around 1-2%.

Symptoms, Signs and Diagnosis of Kidney Reflux

One of the reasons that should come to mind when enlargement is detected by ultrasonography in the kidneys of a fetus followed up in the womb is VUR. VUR should be suspected in every child who has a febrile urinary tract infection in infancy. The most common patient group is girls who come with frequent infections at preschool age. These children may also have day-night incontinence and usually constipation. If deemed necessary in these children, a radiological examination (voiding cystourethrography) is performed by injecting medication into the bladder, which is used for VUR diagnosis.

If VUR is detected, it is understood by performing a kidney scintigraphy (DMSA Scintigraphy) whether it causes any damage to the kidney. For this test, a very small amount of radioactive material is administered intravenously and the losses that may occur due to reflux in the fleshy part of the kidney (renal scar) are evaluated.

Kidney Reflux Treatment

Operation required situations:

1. VURs that are high when diagnosed
2. Situations that are bilateral, even in the 3rd degree, or in which new infection risks cannot be considered due to severe renal scar formation.
3. Having unavoidable infection attacks despite preventive antibiotic treatment

Surgical treatment can basically be done in two ways, either openly or endoscopically. In open surgery, a new junction that does not allow reversal is created at the urinary tract-bladder junction and the success rate is 95%. With the endoscopic intervention, a partial closure is applied to the urinary tract-bladder junction with an injection of a substance, but it is not as successful as open repair. Repeated attempts may be required.