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Vesicoureteric reflux (VUR) - Coggle Diagram
Vesicoureteric reflux (VUR)
Intro
developmental anomaly of VU junctions
ureters displaced lat, enter directly into bladder instead of @ an angle, with a shortened/absent intramural course
Causes
familial
30-50% chance of affected 1st degree relative
secondary to bladder pathology
neuropathic bladder
urethral obstruction
post-UTI (temporary)
Grading severity
Mild
reflux into lower end of undilated ureter in micturition
unlikely to be of significance
Severe
may be a/w renal dysplasia
reflux during bladder filling + voiding
grossly distended ureter + renal pelvis
ureteric dilation important, because...
urine returns to bladder, incomplete voiding, encourages infection + esp pyelonephritis
bladder voiding pressure transmitted back to renal papillae, may contribute to renal damage if high pressure
clubbed calyces
may be a/w IntraRenal Reflux (IRR)
backflow of urine from renal pelvis to papillary collecting duct
a/w v high scarring risk if UTI occurs
controversy about whether scarring is congenitally present or if kidneys normal @ birth + UTI causes scarring
incidence of renal defects increases with increasing VUR severity
Comps
infection may destroy renal tissue - scarring
shrunken poor functioning segment of kidney (REFLUX NEPHROPATHY)
if bilat risk of chronic renal failure
risk of HTN in childhood/early adulthood = 10%
Prognosis
tends to resolve with age, esp if mild