Reflux nephropathy medical therapy
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
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Overview
Medical Therapy
Vesicoureteral reflux is separated into five different grades. Simple or mild reflux often falls into grade I or II. The severity of the reflux and amount of damage to the kidney help determine treatment.
Simple, uncomplicated vesicoureteral reflux (called primary reflux) can be treated with:
- Antibiotics taken every day to prevent urinary tract infections
- Careful monitoring of kidney function
- Repeated urine cultures
- Yearly ultrasound of the kidneys
Controlling blood pressure is the most important way to slow kidney damage. The health care provider may prescribe medicines to control high blood pressure. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are often used.
More severe reflux may need reconstructive surgery. This type of surgery may reduce the number and severity of urinary tract infections.
If needed, patients will be treated for chronic kidney disease.
The aim of treatment is to reduce renal scarring. Those children with grade II or worse should receive low dose prophylactic antibiotics (Nitrofurantoin, trimethoprim, co-trimoxazole, cefalexin in those with CRF).