Nephrology Dialysis Transplantation, Vol 12, Issue 12 2580-2587, Copyright © 1997 by Oxford University Press
J Kohler, J Tencer, H Thysell and L Forsberg
Study purpose: To determine the incidence of urinary
tract infections, hypertension, back pain, and renal calculi in adult
patients with vesicoureteral reflux and reflux nephropathy.
Methods: A group of 115 patients (16-60 years of age,
median 28 years) with vesicoureteral reflux, combined with reflux
nephropathy in 101 patients, first detected between 1967 and 1984, was
studied retrospectively. The group comprised 99 women and 16 men.
Results: Symptoms and findings associated with the
urinary tract preceded the diagnosis of vesicoureteral reflux by median 14
years (1-60 years). Intravenous pyelography preceded investigation with
micturating cystography in 99 patients. Fifteen patients had no urinary
tract infections, 17 patients had only lower urinary tract infections, and
83 patients had upper with or without lower urinary tract infections.
Females had 12 times more lower and seven times more upper urinary tract
infections than males, whereas males had impairment of renal function and
proteinuria more often than females. Hypertension was present in 39
patients (34%) and five times more frequent in patients with bilateral than
in those with unilateral reflux nephropathy. The median age at the first
recording of hypertension was 33 years (16-60 years). Malignant
hypertension was uncommon and occurred in two patients. An older group
(>45 years of age at presentation) of 19 patients showed a 90%
incidence of hypertension compared with 23% in 96 patients in the younger
group (⩽45 years of age at presentation). Back pain of varying type
and severity was present in 48 patients (42%). A total of 38 renal calculi
was found in 21 (18%) patients, of whom 14 were completely asymptomatic.
Conclusions: The natural history of vesicoureteral
reflux first detected in adulthood has shown a strikingly high incidence of
urinary tract infections, arterial hypertension, back pain, and renal
calculi. Key words: hypertension; reflux nephropathy;
renal calculi; urinary tract infections; vesicoureteral reflux
ORIGINAL ARTICLES
Vesicoureteral reflux diagnosed in adulthood. Incidence of urinary tract infections, hypertension, proteinuria, back pain and renal calculi
Department of Nephrology and Department of Radiology, Lund University Hospital, S-22185 Lund, Sweden; Corresponding author
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  J. Kohler, H. Thysell, J. Tencer, L. Forsberg, and M. Hellstrom Conservative treatment and anti-reflux surgery in adults with vesico-ureteral reflux: effect on urinary-tract infections, renal function and loin pain in a long-term follow-up study Nephrol. Dial. Transplant., January 1, 2001; 16(1): 52 - 60. [Abstract] [Full Text] [PDF]
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