Chronic tubulointerstitial disease in which the renal calyces and pelvis are involved with tubulointerstitial inflammation and scarring.
Important cause for end-stage renal disease and an important cause of kidney destruction in children with lower urinary tract abnormalities.
Reflux nephropathy is the most common form of disease with scarring.
Reflux nephropathy occurs in childhood secondary to superimposition of urinary infections on congenital vesicoureteral reflux and intrarenal reflux.
Reflux nephropathy may be bilateral and one or both kidneys and may lead to chronic renal disease.
With chronic obstructive disease the obstruction results in recurrent infections leading to renal inflammation and scarring and parenchymal atrophy.
Kidneys are irregularly scarred with coarse corticomedullary scar overlying a dilated, blunted, or deformed calyx.
Most scars are in the upper and lower poles, consistent wit the likelihood of reflux in these sites.
Microscopic changes involve the tubules and interstitium with tubular atrophy and hypertrophy.