Outcome of Reflux Nephropathy after Surgical Treatment of Vesicoureteral

Vesicoureteric reflux, when present, is one of the most significant host risk factors for acute pyelonephritis in children. In the presence of bacteriuria, reflux promotes direct inoculation of the renal parenchymal by bacteria. Subsequently, an acute inflammatory response occurs with the release of toxic enzymes, focal ischemia and re-perfusion injury, which may result in irreversible renal scarring.Medical management with antimicrobial prophylaxis seeks to maintain sterile urine, rendering the VUR itself relatively harmless, since there are no bacteria present to reach and invade the kidney.Antireflux surgery (ARS), in contrast, reconfigures the ureterovesical junction anatomy to block access to the upper tracts, so that any episodes of cystitis that do occur cannot progress to pyelonephritis. from all studies, we can conclude that the long-term outcome of reflux nephropathy after surgical treatment with regard to renal function, post therapeutic febrile urinary tract infections and arterial hypertension does not differ significantly from the medication group.