Vesicoureteral reflux: More molehill than mountain
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Urinary tract infection (UTI) is a common childhood illness, with a cumulative incidence of 2% to 8% by 10 years of age. Vesicoureteral reflux (VUR) is found in approximately one-third of children who have at least one UTI. The association between VUR and UTI has lead to the concept that VUR plays a pathogenic role in the development of UTI, pyelonephritis, and renal scar formation. This presumed pathologic role has become the basis for current therapeutic modalities designed to avoid renal parenchymal damage. However, neither the pathogenic mechanisms nor the therapeutic modalities has been rigorously validated. Therapeutic recommendations have been based on expert opinion rather than on objective data.
Evidence Based Practice 11(5): 01-03.