Vesicoureteral Reflux (VUR)

Healthy kidneys filter waste from the blood, producing urine which normally flows only one direction: down the ureters and into the bladder. When something is wrong with the connection between the ureter and the bladder, the urine may flow back up (reflux) from the bladder to the ureters and at times to the kidneys.

If you have had vesicoureteral reflux as a child, there is a chance that your children will have the condition. In addition, if one of your children has it, his or her brothers and sisters may also have the condition, too.

Infrequent or incomplete urination, as well as constipation, are also associated with vesicoureteral reflux in children. Frequent urinary tract infections (UTIs) may indicate the presence of vesicoureteral reflux.

 
How is Vesicoureteral Reflux In Children Diagnosed and Treated?

Your Nemours pediatric urologist may order a test called a voiding cystourethrogram (VCUG) that uses X-rays and a special dye to show how your child’s bladder is working. This test can help determine if your child has vesicoureteral reflux.

Vesicoureteral reflux in children is graded on a scale from I (mild) to V (severe). Many times, milder grades of vesicoureteral reflux will go away on their own as your child grows and develops.However, UTIs in the presence of vesicoureteral reflux can cause kidney infections, which can lead to scarring and sometimes result in kidney damage.

Depending on the severity of the vesicoureteral reflux in your child, your Nemours urologist may discuss several treatment options, including antibiotics to prevent infections, surgery to repair the ureters, or endoscopic treatment in which a small telescope is inserted through the bladder and a gel is placed at the point where the ureter meets the bladder.

Urine Test: Calcium

What It Is

A urine calcium test is done to determine how much of the mineral calcium is being excreted in the urine by the kidneys.

Why It's Done

A urine test for calcium is often done to:

  • help determine the cause of kidney stones and other kidney diseases
  • detect overactivity or underactivity in the parathyroid glands (glands in the neck that produce hormones that help control the level of calcium in the blood)
  • monitor disorders of the kidney and diseases of calcium metabolism

Results may also point to digestive disorders that interfere with the small intestine's ability to absorb nutrients. The urine calcium test is usually used in combination with other tests to make a specific diagnosis.

Preparation

The doctor might prescribe a special diet with high or low levels of calcium for a few days before the test. Your child might need to temporarily stop taking specific drugs, such as antacids, that affect calcium levels in the urine.

The Procedure

Collecting the specimen should only take a few minutes. Your child will be asked to urinate into a clean sample cup in the doctor's office. If your child isn't potty trained and can't urinate into a cup, a small catheter may need to be inserted into the bladder to obtain the urine specimen.

Alternatively, a urine collection bag with adhesive tape on one end may be used to collect a sample from an infant. You'll clean your baby's genital area and then arrange the bag around the urinary opening. Once the bag is in place, secure it with the attached tape. You can then put a diaper on your baby. Check your baby's collection bag and remove it after your child has urinated, usually within an hour.

After you bring the sample to the lab, technicians will analyze it for calcium content.

What to Expect

Because the test involves normal urination, there shouldn't be any discomfort as long as your child can provide a urine specimen.

Getting the Results

The results of the urine calcium test are usually available in 1-2 days. Your doctor will go over the results with you and explain what they mean. If abnormalities are found, your doctor may may want to do further tests to make a specific diagnosis.

Risks

Infants may occasionally experience skin irritation from the adhesive tape on the collection bag. If a catheter is used to obtain the urine, it may cause temporary discomfort. If you have any questions or concerns about this procedure, talk to your doctor.

Helping Your Child

Urine collections are usually painless. Explaining how the test will be conducted and why it's being done can help ease any fear. Make sure your child understands that there should be no foreign matter, such as toilet paper or hair, in the sample.

If You Have Questions

If you have questions about the urine calcium test, speak with your doctor.

Reviewed by: Yamini Durani, MD
Date reviewed: February 2012