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Reflux nephropathy — RACP Paediatrics MCQ

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ModerateNephrologyReflux nephropathyRACP Paediatrics

A 4-year-old presents with severe hypertension (180/110 mmHg). She has a history of recurrent UTIs. Renal ultrasound shows a small right kidney with cortical scarring. DMSA scan confirms significant right renal scarring with reduced function (15%). What is the most likely cause of the hypertension?

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Correct answer: B — Reflux nephropathy

Reflux nephropathy (renal scarring secondary to vesicoureteric reflux and recurrent pyelonephritis) is a common secondary cause of hypertension in children. It leads to renal parenchymal damage and subsequent renin-mediated hypertension. The small scarred kidney on DMSA confirms the diagnosis.

Reference: RCH Melbourne – 2023 – Hypertension CPG; RACP Paediatric Curriculum – Nephrology