The role of vesico-ureteric (V-U) reflux in the pathogenesis of kidney scars in the rat.

In Wistar rats V-U reflux with distilled water and sterile saline of varying osmolar strength produces scars in the perihilar region of the kidneys in 80% of animals. Using Indian ink as a marker, rupture of the forniceal epithelium regularly followed V-U reflux. Intrapelvic pressure rose to 120 mm Hg during the reflux procedure. A slowing of proximal tubular transit time was observed by the Lissamine Green technique in the nephrons in the perihilar region immediately after the kidney had been subjected to reflux. It is suggested that the kidney scars which develop after reflux of sterile solutions are ischaemic in origin. It was shown that kidneys damaged by reflux have an increased susceptibility to haematogenous infection.