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Questions posted in the
The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.
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Subject: Re: Kidney Reflux - How long does it take to correct itself on average? Operate? Topic Area: Kidney/Urinary StonesPosted by Lisa on August 07, 1999 at 12:57:48Daughter has borderline Grade 2/Grade 3 in one kidney, Grade 3 in the other.
Posted by HFHS M.D.-BE on August 11, 1999 at 16:05:19
= Dear Lisa, The most important issues for children with reflux are preservation of renal function and trying to assure normal and complete growth of both kidneys. This means avoiding infections of the kidneys to prevent harmful scarring. Sometimes patients are placed on long-term prophylactic antibiotic therapy as your child has been. These regimens are usually safe as long they are tolerated well by the patient. Since your daughter's problem is being managed conservatively(medically), periodic follow-up studies must be done to ensure normal scar free growth. Whether or not reflux would resolve, or when it would resolve, is a variable situation which differs in every patient. Often, however, reflux could persist for a few years before resolving. Also a physical exam should be performed, being certain that height and weight parameters and blood pressure measurements are taken. Laboratory studies should include a urinalysis and urine culture at each visit In terms of radiology tests, an ultrasound and VCUG may be obtained every 18-24 months. After the initial VCUG has been performed to establish a grade, a follow-up study should be performed to determine if any interval change has occurred. On the other hand, surgery or reimplantation of the ureters is a very successful procedure. One should expect success rates as high as 95-98% in patients with normal caliber ureters and normal bladders. This drops to 54% when the ureter is markedly dilated which is seen in grade four and five reflux. There are several schools of thought on whether or not the reflux of sterile urine causes damage to the kidney and alters growth. The decision to proceed with surgical therapy will largely depend on if medical therapy fails, i.e., breakthrough infection while on antibiotics or if the family along with the urologist come to a decision to go ahead with surgery. You definitely need to see a urologist for appropriate follow up and management. Sincerely,
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