The evaluation begins with a complete history and physical examination.

In most cases, the physical exam is normal in someone with reflux nephropathy.

Physical findings in someone with kidney failure caused by reflux nephropathy include:

• Dry skin
• Pale skin
• Muscle atrophy:
• Decrease in the size of muscles
• Leg swelling
• Foot swelling (bilateral)
• Facial swelling
• Arm swelling (bilateral)
• Lethargy:
• Excessive sleepiness
• Confusion

Tests are usually required to make the diagnosis of reflux nephropathy.

Tests that may be used to evaluate reflux nephropathy include:

• Serum calcium
• Serum phosphate level
• Complete blood count
• Erythropoietin blood levels
• Kidney profile
• Includes sodium and potassium levels
• Urinalysis
• 24 hour urine for creatinine clearance

Additional tests that may be used to evaluate reflux nephropathy include:

• Ultrasound of the abdomen
• CT scanning of the abdomen and pelvis
• Intravenous pyelogram
• Cystoscopy
• Allows a doctor to see the abnormal areas causing reflux
• Kidney biopsy
• MRI scan of the abdomen and pelvis
• Retrograde cystourethrogram
• The best test to diagnose this form of reflux

Less commonly performed tests that may be used to evaluate reflux nephropathy:

• Renal arteriogram
• MRI angiography or the renal arteries