Prenatal Risk Factors for Infantile Reflux Nephropathy

Vesicoureteral reflux (VUR) refers to the retrograde flow of the urine from the bladder to the ureter and kidney. In children with a febrile urinary tract infection (UTI), those with reflux are 3 times more likely to develop renal injury compared to those without reflux. Reflux nephropathy was once accounted for as much as 15-20% of end-stage renal disease in children and young adults. With greater attention to the management of UTIs and a better understanding of reflux, end-stage renal disease secondary to reflux nephropathy is uncommon. Reflux nephropathy remains one of the most common causes of hypertension in children. Reflux in the absence of infection or elevated bladder pressure does not cause renal injury. We sought to determine the association of infantile reflux nephropathy (IRN) with prenatal risk factors. In this study, 96 infants with reflux-related renal injury and 96 infants with VUR without reflux nephropathy were evaluated. Maternal information was assessed. Data was analyzed using SPSS version 18. The results of this study showed that age more than 35 years, pre-gestational hypertension, preeclampsia and eclampsia, preterm delivery, very low birth weight (VLBW), pre gestational diabetes mellitus, and maternal BMI<18.5kg/m2 (underweight) were prenatal risk factors for infantile reflux nephropathy. The data suggests that prenatal factors may affect the risk of IRN. Adequate prenatal care and good maternal support can be effective in the prevention of reflux-related renal injury.