Ishii T, Nishioka T, Wakabayashi A, Kunikata S, Matsuura T, Akiyama T, Kurita T, Takemura T, Hanai J
Department of Urology, School of Medicine, Kinki University.
Hinyokika Kiyo. 1988 Mar;34(3):440-5.
Four hundred patients with primary vesicoureteral reflux were followed clinically in our department between 1975 and 1984. Histopathological studies including immunofluorescent study were carried out on 13 of them. Their renal function was followed by intravenous pyelography, and from serum creatinine values, proteinuria and radioisotope renograms. Renal deterioration was found in 4 patients. Proteinuria was observed since the first consultation in three of them. Microscopically, mesangial proliferation was observed in all patients but none of them showed focal glomerulosclerosis. An immunofluorescent study was carried out on 7 patients. IgM deposition was found in 3 patients (43%), C8 deposition in only 2 of 3 patients (29%), IgG deposition in 1 of them (14%), and IgA deposition in 1 patient (14%). Proteinuria, renal disorders and mesangial proliferation were correlated with reflux nephropathy. Especially, intrarenal reflux could cause reflux nephropathy but it is impossible to deny immunological factors.