What is the most likely long-term complication of untreated vesicoureteral reflux?

The long-term complication of untreated vesicoureteral reflux is primarily renal scarring leading to renal insufficiency. Vesicoureteral reflux occurs when urine flows backward from the bladder into the ureters and possibly the kidneys, often due to a malfunctioning valve at the ureter-bladder junction. This abnormal flow can expose the kidneys to increased pressure and recurrent urinary tract infections.

Over time, the chronic reflux and associated infections can lead to scarring of renal tissue, which compromises kidney function. The process of scarring can disrupt the normal architecture of the kidney, impairing its ability to filter blood and concentrate urine, potentially leading to renal insufficiency or even kidney failure if left untreated.

While urinary tract infections, bladder dysfunction, and hydronephrosis are associated complications of vesicoureteral reflux, they do not necessarily lead to the severe long-term effects on kidney function as renal scarring does. Therefore, the focus on renal scarring underlines the critical need for timely diagnosis and management of this condition to protect kidney health.