Vesico-ureteric reflux in Down's syndrome: poor prognosis.

Four patients with Down's syndrome and vesico-ureteric reflux (VUR) are reported. VUR was diagnosed in six renal units and three primary nephrectomies were necessary. Three ureters were reimplanted unsuccessfully in two patients. The 50% nephrectomy rate for reflux nephropathy and the 100% failure rate for ureteric reimplantation in Down's syndrome patients are compared with a nephrectomy rate and ureteric reimplantation failure rate of around 1% for primary VUR in other children.