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Vesicoureteric reflux is a condition where urine flows backward from the bladder to the kidneys. It can be congenital or acquired and may be caused by malformations of the kidneys, kidney disease, or urinary tract infection. Treatments are available to manage vesicoureteric reflux and can include medications, surgery, and watchful waiting to see if the patient starts to experience kidney damage. Patients will usually work with a nephrologist or urologist on managing this condition.
In healthy individuals, the kidneys generate urine and it flows down two small tubes known as the ureters into the bladder. When patients void, the urine pushes through the bladder and urethra to exit the body. Vesicoureteric reflux causes urine to back up in one or both of the ureters, flowing back into the kidneys. This can cause a condition called reflux nephropathy, where the patient develops kidney damage because the urine interferes with kidney function.
Sometimes this condition is congenital, and a fetus may start to develop symptoms or become ill shortly after birth. In other cases, people develop it over time because their kidneys did not form properly, or because of a severe urinary tract infection. A doctor will assess the patient to determine the grade of the vesicoureteric reflux. The lower the grade, the less serious the condition. Low grade conditions may be manageable with medications like antibiotics to prevent infections, as well as regular screening of the patient's kidney health to check for complications.
In patients with a high grade vesicoureteric reflux, it may be necessary to perform surgery. A doctor can rebuild the ureter to address the problem and prevent urine from flowing into the kidneys. If kidney damage is severe, a patient may be a candidate for a transplant. After surgery, the doctor will monitor the patient for signs of recurrence or any complications, and the patient will need to be careful about urinary tract infections, as they could cause a flareup of the vesicoureteric reflux.
Some people have this condition and exhibit no symptoms. This does not necessarily mean no kidney damage is occurring, as kidney function can decline without obvious symptoms. Blood tests provide a measurement of various compounds produced in the kidneys and will provide more information about kidney health, as will medical imaging studies to check on the shape and size of the kidneys. People with vague symptoms like water retention, thirst, and abdominal tenderness may want to get an evaluation, as it is possible they may have kidney problems.