RENAL FUNCTIONAL RESERVE AND MICROALBUMINURIA EXCRETION IN VESICOURETERAL REFLUX AFTER SURGERY CORRECTION

The acute effect of an oral protein load on glomerular filtration rate -renal functional reserve (RFR)- and albumin urinary excretion were e valuated in 9 patients with bilateral vesicoureteral grade IV reflux a fter surgical correction (Group I) and the results compared with 9 chi ldren with repeated urinary infection without reflux (Group II) and 6 healthy controls of similar age (Group III). Intravenous urography, pe rformed in the year of the study, revealed renal scarring in 10 kidney s in Group I and 2 in Group II. All of them had normal values of plasm a creatinine. Basal inulin clearance was significantly lower in vesico ureteral reflux patients. Good correlation was found between parenchym al area of both kidneys and baseline inulin. Following protein load an increase in creatinine and inulin clearance was recorded in urinary i nfection and control children. No change post load was observed in ref lux patients. Microalbuminuria excretion was significantly higher in c hildren with surgical correction during the control period. No changes were observed after load in any of the groups. We conclude that patie nts who had had bilateral vesicoureteral reflux grade IV showed an imp aired renal response to a protein load. Long-term follow-up studies wi ll confirm the value of this test for estimating the risk of further r enal function deterioration in reflux nephropathy.