We used data from the ItalKid Project, a prospective population-based CRF registry of patients undergoing conservative treatment, to evaluate the gender distribution and severity of primary VUR, the age at diagnosis, and the diagnostic and therapeutic methods adopted in children with CRF. The prevalence of males (77.5 % ), the severity of VUR (grade IV-V), and the early age at diagnosis (18 % prenatally) seem to suggest that congenital renal damage is the major cause of pediatric CRF.