A child with recurrent urinary tract infection is most likely to show

Vesicoureteric Reflux VUR is the most common inheritable disease of the genitourinary tract Autosomal dominant mode of transmission Overall incidence is >10 % and in children with UTI is 30 % Majority of cases (75 %) are asymptomatic Major causes of VUR is attenuation of trigone and its contiguous intravesical ureteric musculature Natural history With bladder growth and maturation, most low-grade reflux resolves spontaneously Severe grades of reflux are less likely to resolve Mean age of reflux resolution is 6-7 years Resolution rates : Grades I & II : 80-84%, Grade III: 50%, Grade IV: 20-30%, Grade V: 0-5% Younger children, especially the neonates, are more likely to have spontaneous resolution Reflux of infected urine cause pyelonephritis. Repeated such episodes lead to scarring and nephropathy resulting in hypeension and azotemia If urine is kept sterile, significant nephropathy rarely occurs Ref : Smith's 18th edition Pgno : 191