A 2-year-old girl presents with her second febrile UTI. DMSA scan shows a focal cortical defect in the upper pole of the left kidney consistent with scarring. Which congenital anatomical abnormality is the MOST important risk factor for recurrent UTI and renal scarring in children?
- A Horseshoe kidney
- B Medullary sponge kidney
- C Vesicoureteral reflux (VUR) ✓
- D Unilateral renal agenesis
Correct answer: C. Vesicoureteral reflux (VUR)
Explanation
Vesicoureteral reflux (VUR) is the most important risk factor for recurrent UTIs, ascending pyelonephritis, and renal scarring (reflux nephropathy) in children. Reflux of contaminated urine from the bladder into the upper urinary tract allows bacteria to reach the renal parenchyma, causing pyelonephritis and progressive scarring leading to hypertension and chronic kidney disease. MCUG (micturating cystourethrogram) is the gold standard for VUR diagnosis.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.