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Will my daughter's urinary reflux affect her kidneys?

Q: My 7 years old daughter had recurring urinary tract infection (UTI). Her MCUG test revealed grade III reflux on the left side and the DMSA test suggested that her left kidney was functioning 22% and right kidney was functioning 78%. Her left kidney had scars and the right kidney is normal. She is on prophylaxis antibiotic medicine – Phexin for more than a month now. Her last urine test showed sterile urine. Would reflux harm my daughter’s kidney in future? Do we need to get some more tests done? Can it be treated?

A:The treatment approach of prophylactic antibiotic for your daughter with left sided grade III vesicoureteral reflux (VUR) disease seems to be an appropriate one since it intends to minimise the chances of progressive damage to left kidney including ongoing scarring of the kidney. It is also based on the fact that most VUR do tend to resolve spontaneously. The ongoing reflux of sterile urine while she is on antibiotic (before the spontaneous resolution of the reflux disease) does not cause further scarring. However, if she ends up having recurrent persistent urinary tract infection including of left kidney called pyelonephritis, it would be advisable to seek an opinion of Urologist for surgical intervention.

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