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An increase in urine excretion of albumin has been described in both UPJ obstruction67 and VUR.36,37,68 Elevated excretion of NAG and other proteins, are markers of proximal tubule injury, have been shown in both circumstances, UPJ obstruction41,69,70 and VUR.36,7173 In paediatric medicine there are cases of urinary tract dilation that are not secondary to VUR or to obstruction and there is evidenced elevated pressure in the urinary tract