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Treatment of reflux nephropathy
Last reviewed: 06.07.2025
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The development of reflux nephropathy at any degree of VUR is an indication for surgical correction of reflux.
Before performing surgery, it is necessary to undergo a course of antibacterial therapy to prevent the manifestation or exacerbation of the pyelonephritic process.
In the development of reflux nephropathy in the pre- or postoperative period, it is necessary to take into account that this condition occurs against the background of cellular energy disorders of varying degrees. Therefore, all children are recommended to use succinic acid preparations (yantovit, mitamine) at 25 mg / day, and if there is data on the violation of the activity of mitochondrial enzymes - the use of an extended treatment regimen using drugs whose action is aimed at correcting the state of the mitochondria. In the development of nephrosclerosis, it is advisable to use anti-sclerotic drugs (vitamin B 15, solcoseryl, stugeron, cytochrome C).
The main drugs used in complex treatment in the presence of signs of mitochondrial insufficiency
Name of the drug |
Introduction |
Dosages |
Course of treatment |
Yantovite |
Per os. |
25-50 mg/day |
1-1.5 months. Three days every three days |
Mini yantovite |
Per os |
See #1 |
Same. |
Mitamin |
Per os |
See #1 |
Same |
Elkar |
Per os |
50-100 mg/kg. |
Zmes. |
Coenzyme q10 |
Per os |
30-300 mg/day. |
Zmes. |
Riboflavin |
Per os |
20-150 mg/day. |
1 month |
Thiamine |
Per os |
50 mg/day. |
1 month |
Pyridoxine |
Per os |
2 mg/kg/day. |
1 month |
Lipoic acid |
Per os |
50-100 mg/day. |
1 month |
Vitamin E |
Per os |
100-200 mg/day. |
1 month |
Dimephosphone |
Per os |
15-20 mg/kg |
1 month |
Vitamin B |
Per os |
100 mg/day. |
1 month |
Cytochrome C |
B/m; B/v |
20 mg/day. |
10 days |
Solcoseryl |
B/m |
2 ml/day. |
2-3 weeks |
Conservative treatment must be carried out under constant monitoring of the child's condition using laboratory and instrumental studies (general and biochemical analysis of urine and blood, activity of urine enzymes, blood urea and creatinine levels, ultrasound and Doppler examination of the kidneys, cystography, cystoscopy, intravenous urography and radioisotope examination of the kidneys).
Outpatient observation
Children with vesicoureteral reflux and reflux nephropathy should be followed by a nephrologist before transfer to the adult network.
Outpatient observation includes:
- examination by a nephrologist at least once every 6 months;
- urine analysis monitoring once a month and in case of intercurrent diseases;
- general blood test once every 3 months and in case of intercurrent diseases;
- biochemical blood test with mandatory determination of urea and creatinine levels once every 6 months;
- biochemical analysis of urine once every 6 months;
- analysis of mitochondrial enzyme activity once a year;
- urine enzyme activity analysis once a year;
- cystography after a course of therapeutic treatment, then once every 1-3 years;
- cystoscopy according to indications;
- Ultrasound and Dopplerography of the kidneys once every 6 months;
- radioisotope examination of the kidneys once a year;
- intravenous urography as indicated;
- renal angiography as indicated.
Prevention of the development of vesicoureteral reflux and its complications is its earliest possible diagnosis. This requires antenatal ultrasound to determine the degree of pyelectasis, as well as ultrasound of the kidneys in the neonatal period and in the first year of life.