What is VUR?
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What is the purpose of the RIVUR Study?
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What will happen in this study?
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Who is sponsoring this study?
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How does my child qualify?
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How can I enroll my child?
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RIVUR Study Materials for Parents
 •
Related Publications
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What is VUR?
Vesicoureteral reflux (VUR) is a condition in which urine goes up from the bladder into the ureters during urination. Reflux is graded on a scale of I to V. Grade I is the mildest degree of reflux and Grade V is the most severe degree of reflux. VUR is found in 30-50% of children who have had a urinary tract infection (UTI), and is thought to increase the risk of kidney damage when children have recurrent UTIs.
Currently, most children who are found to have VUR after a UTI are treated with a small daily dose of antibiotics (often for several years) in hope of preventing recurrent UTIs and kidney damage. This practice has been based on information provided by a study during the 1980s in children with VUR who received either prophylactic antibiotics or surgery; an observation group (a group taking placebo medication) was not included in that study. There have been no well-designed research studies to show that long-term antimicrobial treatment is necessary in all children with VUR.
What is the purpose of the RIVUR Study
The purpose of the RIVUR Study (Randomized Intervention for Children with Vesicoureteral Reflux) is to learn whether all children with vesicoureteral reflux (VUR) should be treated with antibiotics. The study will tell us if prophylactic antibiotic treatment prevents urinary tract infections (UTIs) and renal scarring in all children with VUR. The RIVUR Study has the potential to help us understand how to provide the best care for the tens of thousands of children who are diagnosed each year with VUR and UTI.
What will happen in this study?
This study provides the opportunity for 600 children at 19 Children’s Hospitals in the United States to receive close monitoring for urinary tract infections and their kidney health over a two-year period. All participating children will receive excellent care with very close follow-up and early treatment of urinary tract infections. Half of the children will be randomly (Like the flip of a coin.) assigned to a daily dose of an antibiotic and the other half will receive a daily dose of a placebo, a liquid that looks and tastes exactly like the antibiotic, but contains no medicine. During these two years, the parents of all participating children will have direct access to our study team, including kidney specialists, if there are any concerns of another urinary tract infection. The families of the participants will receive educational materials and scheduled phone calls from the study team. Every six months, all of the children in the study will be monitored for urinary tract infections and the development of antibiotic resistance. At the beginning of the study, at the end of one year, and at the end of two years, all of these children will have their kidney functions monitored through blood tests and a DMSA kidney scan. This kidney scan does not require urinary catheterization.
There are safety guards and extremely careful follow-up built into this study to monitor for urinary tract infections and kidney health for all of the children. This national program has the potential to help us to determine how to provide the best care for the tens of thousands of children who are diagnosed each year with reflux and urinary tract infections.
Who is sponsoring this study?
The RIVUR Study is sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and will be conducted in 19 specialty clinics across the U.S.
How does my child qualify?
  • A least 2 months of age, but less than 6 years (72 months) old upon enrollment
  • FIRST or SECOND urinary tract infection (UTI) with either fever or associated symptoms
  • Most recent UTI within 112 days prior to enrollment
  • Treated for the most recent UTI for at least 7 days with an effective antibiotic
  • Vesicoureteral Reflux (VUR) grade I-IV in at least one ureter
  • NO history of other renal injury or disease
  • NO other current or former medical conditions that could interfere with his/her response to the study medication
  • NO allergies to sulfa medications, including trimethoprim-sulfamethoxazole
  • Meet a few additional eligibility requirements
How can I enroll my child?
To find contact information for the RIVUR clinic nearest you, visit our
institutions page
 and click on any of our 19 locations.
RIVUR Study Materials for Parents
Related Publications