Calicotubular backflow, previously reported to occur during retrograde or excretory urographic study, was observed during voiding cystography of eight patients with vesicoureteral reflux. The phenomenon is probably more common than has been demonstrated by present methods. Its connection with pyelonephritis in patients with reflux appears not to have been appreciated. Where calicotubular backflow occurs, bacteria entering the renal pelvis as a result of vesicoureteral reflux can invade the renal parenchyma to initiate, complicate, and perpetuate pyelonephritis.
Amar AD. Calicotubular Backflow With Vesicoureteral Reflux: Relation to Pyelonephritis. JAMA. 1970;213(2):293–294. doi:10.1001/jama.1970.03170280051017
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