Summary of recent AUA guidelines for the management ofvesicoureteral reflux in children

Abstract

VUR is a common condition and it is a predisposing factor for pyelonephritis, and reflux nephropathy, whichcan cause end stage renal disease in children. Given the consequences and sequelae of UTI and VUR, and dueto lack of consensus regarding management of this common condition, the American Urological Association(AUA) developed treatment guidelines for children with VUR in 1997 and 2012 to help physicians bettermanage children with VUR. In this review, the summary of the 1997 and 2012 AUA guidelines are discussedwith a focus on the 2012 report. Recommendations about evaluation and management of children under andabove one year with VUR, with and without bladder/bowel dysfunction, screening of siblings of patientswith VUR, screening of the neonate/infant with prenatal hydronephrosis, and follow up of the children withVUR are discussed in this review. The identification and management of VUR in these groups, provide thepotential opportunity to prevent renal damage and decrease the risk of UTI and pyelonephritis. According tothese guidelines, risk assessment of renal injury/scarring in the individual patient based upon clinical factorsis critical, and interventions should be appropriate to the risk profile. Informing families and healthcareproviders of the potential risk of pyelonephritis and renal scarring and allowing them to participate indecision making is considered important.

Keywords: Urinary tract infection;Vesicoureteral reflux;AUA guidelines