Although reflux occurs more often in females, siblings of both genders should be screened. One study found affected brothers of male children with reflux has a higher grade of reflux and were more likely to have renal scarring than female siblings (Priker, Mohanan, Colhoun, et al, 2006) Screening for reflux in siblings through 72 months of age is recommended to prevent renal damage, which can occur in the absence of symptomatic UTI