Pediatric Vesicoureteral Reflux (VUR)

Pediatric Vesicoureteral Reflux (VUR)

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Summary

Pediatric vesicoureteral reflux (VUR) is marked by urine backing up into the kidney instead of flowing from the kidney and then out of the body.

Expanded Overview

Vesicoureteral reflux is similar to the concept of acid reflux in the digestive system. But, instead of acid backing up in the esophagus, urine flows in the wrong direction,

Urine collects in the kidneys after they filter waste and extra water out of blood. In a healthy kidney, urine flows from the kidney to the ureter, a tube that takes the urine to the bladder. However, with VUR, urine backs up into the kidney.

This leads to unitary tract infections (UTIs), kidney infections and even kidney damage, if not treated.

Types

Vesicoureteral reflux is classified by two types:

  • Primary vesicoureteral reflux — This is a genetic condition that occurs when a child is born with a ureter that didn’t grow long enough. When this happens, the valve that manages the flow of urine between the ureter and bladder doesn’t close properly. This is the most common form of VUR in children and often corrects itself as the child gets older and the ureter gets longer.
  • Secondary vesicoureteral reflux — A blockage in the urinary tract pushes urine back into the ureters and the kidneys. Causes of secondary VUR include nerve damage, infection or pressure on the ureter from another organ.

Causes

Primary vesicoureteral reflux can be inherited (passed down in families). Secondary VUR is caused by nerve damage, infection or pressure on the ureter from another organ.

Symptoms

In most cases, a urinary tract infection is the first sign of pediatric vesicoureteral reflex. Other symptoms include:

Symptoms of vesicoureteral reflux in infants (birth to 1 year*)

Symptoms in children (1 to 19 years old**)

Vesicoureteral reflex can lead to bladder or kidney infections. These infections of the urinary tract can cause different symptoms.

Symptoms of a bladder infection because of VUR:

  • Blood in urine or cloudy, foul-smelling urine
  • Burning sensation while urinating
  • Painful and frequent urinating
  • Urgent need to go the bathroom
  • Wetting because of a lack of urinary control

Symptoms of a kidney or ureter infection because of VUR:

  • Abdominal pain
  • Fever and chills
  • Nausea and vomiting

*Age of infants as defined by the World Health Organization (WHO).
**Age of young children and adolescents as defined by the Centers for Disease Control (CDC).

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