Renal tubular acidosis in children with vesicoureteral reflux

Purpose: We evaluated renal tubular acidosis in children with primary vesicoureteral reflux. Materials and Methods: We studied 18 children 4 to 15 years old to determine age at onset, reflux intensity, and renal scars and volume as possible associated factors of renal tubular acidosis. Patients had normal glomerular filtration rates and no urinary infections for the last 12 weeks, and they had not undergone urological surgery. Urine acidification and alkalization tests were done, and the Mann-Whitney U test was used to assess differences between the groups with and without renal tubular acidosis. Results: A total of 14 patients had unilateral and 4 had bilateral reflux, which varied in severity. All children except 2 had renal scarring. Bilateral renal volume was smaller in the renal tubular acidosis group. Nine patients had distal renal tubular acidosis, including 4 with short stature. Conclusions: Several patients with vesicoureteral reflux had renal tubular acidosis and some had growth failure. Grades of reflux and renal scarring were similar in patients with and without renal tubular acidosis. A single evaluation of reflux is of slight value for predicting future functional tubular impairment, and the duration of reflux and other associated factors may be more important. Renal tubular acidosis was the main explanation for growth failure in these patients.