Diminishing Importance of Screening and Treating Children for Vesicoureteral Reflux After a First Urinary Tract Infection

Abstract

There are few issues in pediatrics that have generated as much controversy as the importance of identifying and treating vesicoureteral reflux (VUR) in children who have been diagnosed with a urinary tract infection (UTI). Until recently, it was thought that bacterial seeding of the urine in the setting of VUR put children at risk of acute pyelonephritis (APN) and renal damage and that this renal damage could lead to renal insufficiency and/or hypertension later in life. Thus, prevention strategies were developed to screen children who have had a UTI for VUR and to prevent recurrent UTIs through antibiotic prophylaxis and/or surgical correction of VUR.¹