Kidney Reflux and Renal Failure

  I was diagnosed with kidney reflux when I was 10 (19 yrs ago) and operated on, as affected kidney was damaged 90% and unaffected was enlarged.  Now after yearly checks, creatinine levels are raising and the creatinine clearance levels are dropping rapidly. Dropped from 1.03 to .78 in one year. Bathroom breaks are VERY regular (every hour or two)  My M.D. suggests sugar testing and some others.  Wants to send me to a nephrologist, can't stand another catheter in my life.  Can your kidneys worsen and fail you even after corrective surgery?  Ever heard of dropping numbers even after surgery?  
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Dear Cynthia,
Patients with vesicoureteric reflux who have impaired renal function at the time of diagnosis, carry a high risk for progressive renal deterioration even after the surgery.  This occurs due to a condition known as reflux nephropathy, meaning these patients have inherently diseased kidney, which gets further damaged by immunological mechanisms or continued infections.  Presence of hypertension and proteinuria (protein in the urine) usually carry less favorable prognosis.
You should try to keep the blood pressure controlled (if it is high), avoid very high protein diet, and do not take any over the counter drug which can damage the kidneys further (such as anti-inflammatory analgesics) and keep a check on your blood sugar.  
Increased frequency of urination may either suggest infection in the bladder or detrusor instability.  You may want to get this checked by an urologist who may arrange for a urodynamics, if there is no infection.  Presence of detrusor instability usually makes the reflux worse.   At this time consultation with a nephrologist or urologist will certainly help you in making future management decisions.
This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
The Henry Ford Hospital Department of Urology has experience in the evaluation and treatment of problems such as you describes. They would be most interested in helping you. You can reach them through our toll-free number (1-800-653-6568). We can also arrange local accommodations through this number if this is your need.
Sincerely,
HFHS M.D.-A.T.
*keyword: Reflux nephropathy