Reflux Nephropathy

By | June 8, 2022

Reflux nephropathy describes kidney disease. It is characterized by a backflow of urine into the upper urinary tract. This can lead to various symptoms and complications of kidney function.

What is reflux nephropathy?

Vesicourethral reflux describes the reverse flow of urine from its natural direction.

Once it has reached the urinary bladder, it runs back through the ureters and finally into the kidneys. For meanings of carotid stenosis (narrowing of the carotid artery), please visit

This leads to numerous complaints and impairments of the kidney function up to and including damage.

Reflux nephropathy is usually characterized by frequent infections of the urinary tract and inflammation of the renal pelvis.

These can be very painful and pose health risks. Flank pain sometimes also occurs.


The cause of the so-called reflux nephropathy is the reflux of urinary fluid into the renal pelvis. Malformed urinary tracts, which are already congenital, are often responsible. In healthy ureters, fluid is drawn from the kidneys directly into the bladder in a peristaltic waveform by the muscles. Normally, it is not possible for urine to flow backwards, since the movements take place in the opposite direction.

Symptoms, Ailments & Signs

Reflux nephropathy can cause various complications. Infections such as urinary tract infections, bladder infections, growth disorders in children and inflammation of the renal pelvis often occur. In addition to the impairment of kidney function, inflammation of the renal pelvis also causes pain and fever.

The patient feels very bad overall. When the bladder becomes inflamed, there is usually a painful burning sensation in the urinary tract. The cause of reflux nephropathy are congenital defects in the ureteral ostium closure. Here the ureters are shortened and thus trigger the typical symptoms. The urine is pushed back into the kidneys.

This also allows various pathogens to penetrate, which then trigger further kidney diseases. The pressure in the kidneys is constantly increased. Because of this, the urinary tract expands in the kidneys. This circumstance also contributes to the fact that germs and bacteria can penetrate more easily.

Diagnosis & course of disease

The easiest way to diagnose reflux nephropathy is with ultrasound. The doctor has the opportunity to reliably determine the malformations and pathological bottlenecks. Pain is not caused during the examination. Sometimes it is also necessary to place a urinary catheter, but only for a limited period of time.

This extends from the urethra to the bladder. It only causes an uncomfortable feeling, but does not hurt. If necessary, a contrast medium is fed into the bladder via the catheter. This gives the doctor the opportunity to use X-rays to see whether and how much urine is flowing back.


Reflux nephropathy can lead to various complications. Urinary tract infections, bladder infections and chronic pain are common. Inflammation of the renal pelvis is also typical, which, in addition to impairing kidney function, can also cause fever, circulatory problems and other infections. If there are undiagnosed diseases or if the patient is taking certain medications, serious problems with the cardiovascular system can occur.

In general, the disease leads to a decrease in the well-being and quality of life of those affected. In the case of longer-lasting illnesses, this can lead to serious mental illnesses that require independent treatment. Kidney disease can cause stunted growth in children. Typical complications of treatment are side effects and interactions from antibiotics as well as infections and injuries from surgical intervention.

A new ureter implantation in particular is risky, as the scarring can lead to narrowing of the blood vessels. Catheter placement can also lead to infection, tissue damage, and bleeding. There is also a risk of sore spots becoming inflamed. In individual cases, there is further irritation of the urinary tract, which in turn is associated with complications.

When should you go to the doctor?

Treatment is always necessary for reflux nephropathy. This condition cannot be treated by self-help means and if left untreated can lead to various symptoms and complications. A doctor should be consulted if the patient suffers from persistent cystitis. Children can also show disturbances in growth or thriving and very often suffer from fever.

As a rule, a restricted function of the kidneys is also a clear sign of reflux nephropathy and should therefore be examined by a doctor in any case. This leads to a burning sensation in the urinary tract and a significantly reduced quality of life for the patient. In the worst case, the person affected suffers from complete renal insufficiency, from which he can also die.

Reflux nephropathy is usually treated by a urologist or an internist. In acute emergencies, you should go to the hospital or call an ambulance. Early diagnosis and treatment always have a very positive effect on the further course of the disease.

Treatment & Therapy

Reflux nephropathy can damage the kidneys of those affected. In such a case, an operation is usually necessary. The insufficiency of the kidneys can no longer be corrected. In the worst case, regular dialysis or a kidney transplant may be necessary. A blood test can determine how badly the kidneys have been damaged.

Bladder and kidney infections are treated with various antibiotics. In most cases, however, an operation is unavoidable. If the defect is in a place where the ureters open, endoscopy can now be used. The endoscope is inserted into the urethra. The doctor then has the opportunity to look into the bladder with a small camera. Treatments can also be carried out with this method.

The endoscope works very precisely and allows substances to be injected into the urinary ducts in order to close the openings of the openings to the kidneys. This prevents backflow. Nevertheless, an operation is always necessary when these openings are too large and cannot be closed. The operation is an invasive procedure in which the abdominal wall is opened.

The ureters are surgically connected to the bladder at the intended point. This procedure is known as ureter reimplantation and is often necessary in the case of a reflux nephropathy. However, if the symptoms occur at bottlenecks in the ureters, the aim is to remove the narrowed areas. The ureters are then reconnected.

The last resort is often kidney and ureter removal. This is always necessary when kidney performance falls below 20 percent or the function comes to a complete standstill. However, this rarely happens. Early treatment is therefore of great importance in reflux nephropathy.


Reflux nephropathy is difficult to prevent. It is a congenital defect affecting the opening of the two ureters to the bladder and kidneys. This malformation is the most common. Sometimes surgery is necessary to fix the defect. The most common complaints and complications are infections of the bladder and kidneys, which are favored by the easier penetration of germs.

However, it is quite possible that reflux nephropathy causes little or no symptoms, so that sometimes only symptomatic treatment is required. In children, the defect can still be regulated as they grow. In adulthood, surgery is usually very helpful.

Antibiotics are often prescribed to prevent infectious diseases such as bladder and kidney infections. Any further preventive measures are basically not possible, since reflux nephropathy is a congenital malformation of the urinary tract, which also directly affects the kidneys.


After a successfully treated reflux nephropathy, certain follow-up measures are necessary, which can depend on the severity and the therapy of the reflux nephropathy. The most important thing and necessary in all cases is regular follow-up examinations of the kidneys, bladder and urinary tract.

As a rule, this is carried out by means of ultrasound examinations by the treating doctor. Since thatriskfor urinary tract infections in people with reflux nephropathy is increased even after their treatment, regular monitoring of the inflammatory values ​​in the blood can also be helpful in recognizing urinary tract infections at an early stage and treating them with antibiotics in good time so that the kidneys do not become inflamed.

The risk of increased blood or CSF pressure is increased in people with reflux nephropathy even after their successful treatment. This also applies if the blood pressure or CSF pressure was not too high during the acute reflux nephropathy. Therefore, blood pressure and CSF pressure (cerebrospinal fluid pressure) should be checked regularly.

If there is increased blood pressure or increased liquor pressure, this must be treated separately with medication unless it decreases on its own as a result of successful therapy for reflux nephropathy. If the CSF pressure increases, it may also be necessary to remove several milliliters of CSF during a lumbar puncture and, if necessary, to surgically insert a shunt to reduce the pressure.

You can do that yourself

Patients with this disease, which is often caused by malformations, often suffer from painful urinary tract infections and inflammation of the kidneys. This reduces the quality of life and can lead to growth retardation in children.

In the case of an acute infection, it is important to take the prescribed antibiotics according to the doctor’s instructions, otherwise the symptoms can worsen massively. The doctor may also recommend surgery.

Irrespective of this, patients should ensure a particularly healthy lifestyle in order to support the body’s own immune system. A well-functioning immune system can fight the recurring infections better. A healthy lifestyle includes a healthy diet rich in vitamins and minerals with fresh ingredients, getting enough sleep and drinking water regularly. Patients should largely avoid fast food, nicotine and alcohol. Exercise in the fresh air, such as walking, hiking or jogging, also supports the immune system. If possible, patients should also exercise. Team sports in particular also stabilize the psyche.

If the symptoms of reflux nephropathy lead to persistent moodiness, psychotherapeutic concomitant therapies are indicated. Joining self-help groups can also help. Addresses of nearby self-help groups can be obtained from the urologist or the treating clinic.

Reflux Nephropathy