ABSTRACT
Primary vesico-ureteral reflux (VUR) is the most common
urological anomaly in children. It occurs in 12% of the pediatric population and in 3050% of children who present with urinary tract infection.1,2 The association of vesico-
ureteral reflux, urinary tract infection, and renal damage is
well known. Marra et al.3 reviewed data on children with
chronic renal failure who had high-grade VUR in the Italkid
project, a database of Italian children with chronic renal
failure and found that those with VUR accounted for 26% of
all children with chronic renal failure. Parenchymal injury in
vesico-ureteral reflux occurs early, in most patients before the
age of three years. Kidneys of young infants are more
vulnerable to renal damage. Most renal scars are present
when reflux is discovered at initial evaluation for urinary
tract infection.