What Is Vesicoureteral Reflux (VUR)?
It’s imperative for parents and caregivers to be aware of the various medical conditions that can impact their child’s health and pediatric care. In many cases, an honest pediatrician can make the difference between patients reaping the consequences of preventable harm and shielding them from damage that can be avoided with proper care and screening.
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When it comes to diagnosing kidney and bladder issues in pediatric patients, VUR is a common cause of concern for U.S. families. Vesicoureteral reflux (VUR) is a condition in which the urine flows backward from the bladder into the ureters and even the kidneys.
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Normally, urine flows from the kidneys to the bladder through tubes called ureters in one direction. However, in VUR, a malfunction in the valve-like mechanism between the ureters and bladder causes this backward flow. VUR is more common in infants and young children, and those with VUR are often born with the condition.
While the exact percentage of kids affected by VUR is still unknown, research reflects that approximately 1 in 100 children are diagnosed with the condition.
Understanding VUR: A Guide for Parents
WHAT CAUSES VUR?
There is no single cause of VUR, although experts believe that genetics play a significant factor in developing VUR. Some potential causes of VUR include:
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Genetic Factors. VUR can be hereditary, meaning it can be passed down from parents to their children. If a family member, particularly a parent or sibling, has a history of VUR, the child is at a higher risk of developing the condition.
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Abnormal Development of the Urinary Tract. In some cases, VUR can occur due to structural abnormalities or malformations in the urinary tract. These abnormalities can affect the proper functioning of the valve-like mechanism between the bladder and ureters, leading to urine reflux.
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Urinary Tract Infections (UTIs). UTIs are a common risk factor for VUR. When a child experiences frequent or recurrent UTIs, it can increase the likelihood of developing VUR. Infections in the urinary tract can cause inflammation and weaken the valve mechanism, allowing urine to flow backward.
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Gender. Girls are more prone to VUR than boys, particularly in mild cases. The exact reason for this gender difference is not fully understood, but it may be related to anatomical and hormonal factors.
SIGNS OF VUR IN CHILDREN
Vesicoureteral reflux (VUR) may not always present visible symptoms, especially in milder cases. However, there are common signs that caregivers can and should be on the lookout for to prioritize their child’s health and wellbeing.
Common symptoms of VUR include:
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Recurrent UTIs
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Fever and/or abdominal pain
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Poor growth or weight gain
RESOURCES FOR KIDNEY REFLUX (VUR)
Voiding cystourethrogram (VCUG) is the alleged “gold standard” diagnostic test for vesicoureteral reflux (VUR), also known as kidney reflux.
How many children have VUR?
What are the risks of VUR?
Who is at risk of VUR?
How many VCUGs are performed annually?
VUR occurs when one or both ureters is too short, preventing the bladder from emptying normally. This condition is believed to affect 1-3% of all infants and children, although research suggests this percentage may be much higher. Most children with VUR are born with it. The cause is unknown.
The risks of VUR vary widely from child to child. This can make it difficult to determine ideal treatment options and the anticipated severity of symptoms and effects. Left untreated, VUR can lead to a range of symptoms, including urinary tract infections (UTIs), kidney infections, or renal scarring.
Because boys typically outgrow VUR by age 2, young girls are predominantly impacted by VUR, and thus undergo more VCUGs. Many patients experience repeated VCUGs in childhood until VUR resolves on its own, a common occurrence in many pediatric patients with the condition. Many patients will experience repeated VCUG tests until their VUR spontaneously resolves, or a surgical intervention is performed, usually before age 10.
Our team is conducting ongoing research to determine how many children undergo VCUG testing on an annual basis. While hospitals and medical entities decline to disclose this information, experts predict that up to 1 million children undergo VCUGs every year on a global scale, including ~400,000 VCUGs in the U.S.
VUR is not only the most common urinary tract pathology among children, but is also the most controversial topic within pediatric urology.