A long term follow up of adults with reflux nephropathy.

Aim: To assess the long term follow up of patients with reflux nephropathy.
Methods: Two hundred and ninety-four patients over 15 years of age (females 235; caucasians 288) presented between 3 wk and 72 yr of age (mean 17.3 yr; SD 14.4 yr). One hundred and seventy-six had unilateral reflux nephropathy and 118 had bilateral reflux nephropathy diagnosed on intravenous urography and/or a DMSA scintigraphy.
Results: The majority of patients, particularly women, presented with a urinary tract infection. Twenty-five patients (8.5%) had hypertension at presentation, 15 (5.1%) loin or abdominal pain, 14 (4.8%) proteinuria and six (2%) renal insufficiency. At the last follow up (mean age 34.2yr; SD 13.7yr; range 15-81yr), 113 patients (38%) had hypertension or were on antihypertensive therapy. This was significantly more frequent in those with severe bilateral renal parenchymal scarring. Proteinuria was present in 92 (31%); 40 of these had renal insufficiency. Seventy-one (24%) had a creatinine clearance < 70 mL/min and 43 (15%) a urinary tract infection. Eighteen patients had suffered from a urinary calculus. Proteinuria and renal insufficiency were significantly more frequent in those with severe bilateral reflux nephropathy.
Conclusion: All patients with reflux nephropathy who have proteinuria, hypertension or renal insufficiency should be under regular follow up.