Postnatal diagnosis Vesicoureteral reflux is suspected postnatally in patients with any of the following: UTI at age ≤ 3 years Febrile UTI at age ≤ 5 years Recurrent UTIs in children UTI in males Strong family history, such as a sibling with VUR (controversial) Adults (or children > 5 years) with recurrent UTI in whom renal ultrasonography reveals scarring or a urinary tract anatomic abnormality Laboratory abnormalities may include proteinuria, sodium wasting, hyperkalemia, metabolic acidosis, renal insufficiency, or a combination.