<prompt> 8 yr old child with BP 180100 mm Hg, urea 90, creatinine 5.3, urinalysis shows 15-20 pus cells, l2 RBC, protein 1-1- has no significant past ho of similar complaint. Most likely diagnosis is?Post infective glomerulonephritisAccelerated hypeension with ARFIdiopathic RPGNChronic interstitial nephritis with VUR  <response>: Ans is d i.e., Chronic interstitial nephritis with VUR o This child is having: i Elevated BP Hypeension ii Elevated BUN 90 and Creatinine 5.3 -ARE iii 15-20 Pus cells -- Pyuria iv No hematura 1-2 RBC --- for microscopic hematuria to be significant, 5-10 RBCsj.iL of urine are required v Minimal proteinuria 1 o Post-infective glomerulonephritis and idiopathic RPGN have significant hematuria as they present as nephritic syndrome. So, these options are ruled out. o Accelerated hypeension with ARF cannot explain the presence of pyuria. So, this option is alos excluded. o Now we are left with option d. vesicoureteric reflux in children may cause chronic interstitial rephritis. Chronic interstitial nephritis may have all the features given in the question: i Hypeension is common ARF may occur in VUR iii Pyuria is common due to recurrent infection Proteinuria in chronic interstitial disease is mild 