Vesicoureteral reflux is separated into five different grades. Simple or mild reflux often falls into grade I or II. The severity of the reflux and amount of damage to the kidney help determine treatment.
Simple, uncomplicated vesicoureteral reflux (called primary reflux) can be treated with:
- Antibiotics taken every day to prevent urinary tract infections
- Careful monitoring of kidney function
- Repeated urine cultures
- Yearly ultrasound of the kidneys
Controlling blood pressure is the most important way to slow kidney damage. The health care provider may prescribe medicines to control high blood pressure. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are often used.
Surgery is usually only used in children who have not responded to medical therapy.
More severe vesicoureteral reflux may need surgery, especially in children who do not respond to medical therapy. Surgery to place the ureter back into the bladder (ureteral reimplantation) can stop reflux nephropathy in some cases.
More severe reflux may need reconstructive surgery. This type of surgery may reduce the number and severity of urinary tract infections.
If needed, patients will be treated for chronic kidney disease.