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June 19, 1981

Reflux Nephropathy

JAMA. 1981;245(23):2430. doi:10.1001/jama.1981.03310480046030

Although ureterovesical reflux in children was described as early as 1897,1 and the glomerular changes that often ensue if these children survive to adulthood were noted half a century ago,2 reflux nephropathy—a term embracing both the etiology and the sequel—is still incompletely understood. Currently, however, with opportunities provided by improved histological and histoimmunologic techniques, this condition is undergoing extensive investigation.

Two recent studies—one from Lexington, Ky,3 the other from the Mayo Clinic4—shed more light on the development of reflux nephropathy and its response to renal transplantation. Their conclusions are not always in accord.

Bhatena et al3 of the Lexington group studied 23 patients with reflux nephropathy between 1973 and 1977. All 23 underwent nephrectomies with subsequent renal transplantation, and all manifested focal and segmental glomerulosclerosis in their native kidneys. The lesions appeared to evolve from early glomerular hypertrophy to focal and segmental and occasionally