10 month old has VUR grade 2 in both kidneys. What can we do now?

Question

Hello doctor,

I have a 10-month-old daughter. She had UTI several times. After VCUG, we realized that she has VUR grade 2 in both kidneys. The DMSA scan interpretation was that low-lying small-sized right kidney with a cortical defect in the inferior half. Mild reduced cortical function in the inferior pole of the left kidney with prominent PSC. The renal function of the right kidney is 30 %, and the left kidney is 70 %. What can we do now?

Answer 1

Hello,

Welcome to icliniq.com.

Sorry to hear about your daughter. As you rightly infer, she has vesicoureteric reflux. Right is more affected than left. This severity of affection is usually not expected, though, from grade II reflux. Hence, there is a possibility of independent kidney affection for her, apart from VUR, by birth. However, that does not affect our management. It is just an observation.

As per current guidelines, her management involves:

Antibiotic prophylaxis for urinary infection till the age of 6 years.
Monthly urine routine and urine culture if needed.
Antibiotics, if we find infection in urine, even if she is asymptotic.
Testing for urine protein, which can give an idea of the severity of the disease.
Yearly DMSA (dimercapto succinic acid) and considering surgical correction if new scar develops or reflux grade increase (which is unlikely).
Complete her vaccinations and good nutrition.

Hope the answer helped you. Feel free to revert if you have any more query.