Reflux nephropathy complicated by acute post-streptococcal glomerulonephritis.

A 7 years old male with severe bilateral vesicoureteral reflux developed acute renal failure without evidence of either infection or obstruction. The diagnosis of acute post-streptococcal glomerulonephritis was confirmed by clinical, serological and histological evaluation. The patient's creatinine clearance decreased from 25 ml/min/1.73 m2 to 10-13 ml/min/1.73 m2 following the acute nephritic episode and chronic dialysis therapy was required thereafter. This patient illustrates that a glomerular etiology should be suspected when acute renal failure occurs in a patient with reflux nephropathy and suggests that the prognosis of acute post-streptococcal glomerulonephritis may be worse in children with pre-existing renal disease.