IntroductionChronic atrophic pyelonephritis is a main cause ofsustained hypertension and renal insufficiency inchildren and young adults.'2 As the inflammatoryreaction is minimal in this stage of the disease processpostinfectious focal renal scarring is a more appropriatedescriptive term. The main factors predisposing to theinitiation of a focal scar are well known: young age (<3-4 years), virulent bacterial strains, delay between onsetof infection and start of antibiotic treatment, andsevere vesicoureteric reflux with intrarenal reflux.Because of this last association the condition is alsocalled reflux nephropathy. As it highlights only one ofthe main predisposing factors and reflux is not alwayspresent the term reflux nephropathy is less accurate.
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