Family screening programs offer the prospect of detecting hereditary v
esicoureteric reflux before scars develop with urinary infections. Thi
s review describes minor to severe reflux and reflux nephropathy (RN)
in five families where a member developed renal failure. including 3 c
hildren who developed both scars and renal failure, Analysis of famili
es in the literature demonstrated similar phenotypic variation and the
regular detection of both sterile reflux and RN by screening. Future
systematic family studies could evaluate the predictive value of ultra
sound in detecting significant reflux, assess the severity of congenit
al RN found in infants, and compare prophylactic regimes with historic
controls.