Brakeman Paul
Division of Pediatric Nephrology, Department of Pediatrics, University of California, San Francisco, CA 94143-0532, USA.
Adv Urol. 2008;2008:508949. doi: 10.1155/2008/508949.
To review the contribution of vesicoureteral reflux and reflux nephropathy to end-stage renal disease.
Published research articles and publicly available registries.
Vesicoureteral reflux (VUR) is commonly identified in pediatric patients and can be associated with reflux nephropathy (RN), chronic kidney disease (CKD), and rarely end-stage renal disease (ESRD). Patients with reduced GFR, bilateral disease, grade V VUR, proteinuria, and hypertension are more likely to progress to CKD and ESRD. Because progression to ESRD is rare in VUR and often requires many decades to develop, there are limited prospective, randomized, controlled trials available to direct therapy to prevent progression to ESRD.
Identification of patients with increased risk of progression to CKD and ESRD should be the goal of clinical, biochemical, and radiological evaluation of patients with VUR. Treatment of patients with VUR should be directed at preventing new renal injury and preserving renal function.
回顾膀胱输尿管反流及反流性肾病对终末期肾病的影响。
已发表的研究文章及公开可用的登记资料。
膀胱输尿管反流（VUR）常见于儿科患者，可与反流性肾病（RN）、慢性肾脏病（CKD）相关，极少与终末期肾病（ESRD）相关。肾小球滤过率降低、双侧病变、V级VUR、蛋白尿及高血压患者更易进展为CKD和ESRD。由于VUR进展至ESRD罕见且往往需要数十年时间，因此可供指导预防进展至ESRD治疗的前瞻性、随机、对照试验有限。
识别进展为CKD和ESRD风险增加的患者应成为VUR患者临床、生化及影像学评估的目标。VUR患者的治疗应旨在预防新的肾损伤并保留肾功能。
