The distribution of renal scars in children with vesicoureteral reflux (VUR) and a past history of urinary tract infection was studied to see whether a correlation existed between renal scarring and intrarenal reflux. In 37 children with one or more scars in one or both kidneys, scarring was significantly more frequent in the polar areas than in the lateral area. In 7 children with intrarenal reflux (IRR), the distribution of IRR was almost identical with that of renal scarring. When children with marked VUR (grade IV-V) were analyzed separately, a uniform distribution of scars was found. It was concluded that fused papillae, which normally are most frequent in the polar area, are a prerequisite for the development of IRR/renal scars.
BourneH. N.CondonV. R.HoytT. S.NixonW.: Intrarenal reflux and renal damage. J. Urol.115 (1976), 304.
2.
ClaëssonL.JacobssonB.OlssonT.RingertzH.: Assessment of renal parenchymal thickness in normal children. Acta Radiol. Diagnosis22 (1981), 305.
3.
FillyR.FriedlandG. W.GovanE. D.FairW. R.: Development and progression of clubbing and scarring in children with recurrent urinary tract infection. Radiology113 (1974), 145.
4.
HeikelP. E.ParkkulainenK. V.: Vesicoureteric reflux in children. Ann. Radiol.1 (1966), 37.
5.
HeptinstallR. H.HodsonC. J.: Pathology of sterile reflux in the pig. Congr. Nephrol.38 (1984), 344.
6.
HodsonC. J.: Radiological diagnosis of renal involvement. Urinary tract infection. Oxford University Press, London1968.
7.
Scoring the damage. In: Reflux nephropathy, p. 29. Edited by HodsonJ.Kincaid-SmithP., Masson Publishing, New York1979.
8.
HodsonJ.Kincaid-SmithP.MalingT. M. J.McManamonP. J.LewisM. G.: The pathogenesis of reflux nephropathy (chronic atrophic pyelonephritis). Brit. J. Radiol. (1975) Suppl. No. 13.
9.
MalingT. M. J.McManamonP. J.LewisM. G.TwohillS. T.: The time factor in the development of sterile renal scarring following high-pressure vesicoureteral reflux. Congr. Nephrol.39 (1984), 358.
10.
HulandH.BuschR.: Pyelonephritic scarring in 213 patients with upper and lower urinary tract infections. Longterm follow-up. J. Urol.132 (1984), 936.
11.
Kincaid-SmithP.: Clinical implications of reflux in the adult. Proceedings of the Eighth International Congress of Nephrology, Athens 1981.
12.
LevittS. B.: Medical versus surgical treatment of primary vesicoureteral reflux. Pediatrics67 (1981), 392.
13.
RansleyP. G.: The renal papilla, intrarenal reflux and chronic pyelonephritis. Proceedings of the Eighth International Congress of Nephrology, Athens 1981.
14.
RansleyP. G.RisdonR. A.: Reflux and renal scarring. Brit. J. Radiol. (1978) Suppl. No. 14.
15.
RisdonR. A.The renal papilla, intrarenal reflux and chronic pyelonephritis. In: Reflux nephropathy, p. 126. Edited by HodsonJ.Kincaid-SmithP., Masson Publishing, New York1979.
16.
RollestoneG. L.MalingT. M. J.HodsonC. J.: Intrarenal reflux and the scarred kidney. Arch. Dis. Child.49 (1974), 531.
17.
RoseJ. D.GlassbergK. I.WaterhouseK.: Intrarenal reflux and its relationship to renal scarring. J. Urol.113 (1975), 400.
18.
ScottJ. E. S.: The management of ureteric reflux in children. Brit. J. Urol.49 (1977), 109.
19.
SmellieJ. S.HodsonC. J.EdwardsD.NormandI. C. S.: Clinical and radiological features of urinary infection in childhood. Brit. Med. J.2 (1964), 1222.
20.
SmellieJ. S.HodsonC. J.EdwardsD.NormandI. C. S.EdwardsD.HunterN.NormandI. C. S.PrescodN.: Vesicoureteric reflux and renal scarring. Kidney Int.8 (1975), 65.
21.
TamminenT.KaprioE.: The relation of the shape of renal papilla and of collecting duct openings to intrarenal reflux. Brit. J. Urol.49 (1977), 345.
22.
ThomsenH. S.TalnerL. B.HigginsC. B.: Intrarenal backflow during retrograde pyelography with graded intrapelvic pressure. Invest. Radiol.17 (1982), 593.
23.
WikstadI.AperiaA.BrobergerO.EkengrenK.: Vesicoureteric reflux and pyelonephritis. Long-time effect on area of renal parenchyma. Acta Radiol. Diagnosis20 (1979), 252.
24.
WikstadI.AperiaA.BrobergerO.EkengrenK.LöhrG.: Long-time effect of large vesicoureteral reflux with or without urinary tract infection. Acta Radiol. Diagnosis22 (1981), 325.
