Risk factors for renal scarring after first febrile urinary tract infection
DOI:
https://doi.org/10.25753/BirthGrowthMJ.v25.i1.8820Keywords:
urinary tract infection, renal scar, renal scintigraphyAbstract
Introduction: The urinary tract infection (UTI) is one of the most common paediatric infectious diseases and it increases the risk for hypertension and end-stage renal disease. Authors’ aim was to identify risk factors for permanent renal injury after a first febrile urinary tract infection.
Methods: Retrospective analysis of clinical, laboratorial and imaging data of children aged 1 to 36 months hospitalized between January 2010 and December 2012 with the first febrile UTI, comparing with late renal scintigraphy results.
Results: Seventy seven children were included - 53% female, median age of 5 months, Escherichia coli identified in 95%. Renal scintigraphy, performed after the acute episode, revealed renal scars in 19.5%. Cystourethrography was done in 21 patients and vesicoureteral reflux identified in 3. There was no statistically difference between children with and without renal scarring regarding gender, age, body temperature, C-reactive protein, plasmatic creatinine level, bacteriuria or urine nitrite test, urine bacteria identified, presence of vesicoureteral reflux or recurrence rate of UTI.
Conclusions: The authors did not detect any clinical, laboratory or imaging data that may predict progression to renal scarring following a first episode of febrile UTI in children between 1 and 36 months.
Downloads
References
Vachvanichsanong P. Urinary tract infection: one lingering effect of childhood kidney diseases – review of the literature. J Nephrol 2007; 20: 21-8.
Shaik N, Ewing A, Bhatnagar S, Hoberman A. Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics 2010; 126: 1084-90.
Oh M, Cheon J, Kang S, Park H, Lee J, Moon D. Predictive factors for acute renal cortical scintigraphic lesion and ultimate scar formation in children with first febrile urinary tract infection. J Urol 2010; 183: 1146-50.
Pecile P, Miorin E, Romanello C, Vidal E, Contardo M, Valent F, Tenore A. Age-related renal parenchymal lesions in children with first febrile urinary tract infections. Pediatrics 2009; 124: 23-9.
Jakobsson B, Svensson L. Transient pyelonephritic changes on 99mtechnetium-dimercaptosuccinic acid scan for at least five months after infection. Acta Paediatr 1996; 86: 803-907.
Preda U, Jodal U, Sixt R, Stokland E, Hansson S. Imaging strategy for infants with urinary tract infection: a new algoritmo. J Urol 2011; 185:
-52.
Shaik N, Craig J, Rovers M, Da Dalt L, Gardikis S, Hoberman A, et al. Identification of children and adolescentes at risk for renal scarring after a first urinary tract infection: a meta-analysis with individual patient data. JAMA Pediatr 2014; 168: 893-900.
Ehsanipour F, Gharouni M, Rafati A, Ardalan M, Bodaghi N, Otoukesh H. Risk factos of renal scars in children with acute pyelonephritis. Braz J Infect Dis 2012; 16: 15-8.
Lee Y, Lee J, Park Y. Risk factors for renal scar formation in infants with first episode of acute pyelonephritis: a prospective clinical study. J Urol 2012; 187: 1032-6.
Keren R, Shaik N, Pohl H, Graevns-Mueller L, Ivanova A, Zaoutis L, et al. Risk factors for recurrent urinary tract infection and renal scarring. Pediatrics 2015; 136: 13-21.
Wennerstrom M, Hansson S, Jodal U, Stokland E. Primary and acquired renal scarring in boys and girls with urinary tract infection. J Pediatr 2000; 136: 30-4.
Coulthard M, Lambert H, Keir M. Do systemic symptoms predict the risk of kidney scarring after urinary tract infection? Arch Dis Child 2009; 94: 278-81.
Downloads
Published
How to Cite
Issue
Section
License
Copyright and Authors' Rights
All articles published in Nascer e Crescer - Birth and Growth Medical Journal are Open Access and comply with the requirements of funding agencies or academic institutions. For use by third parties, Nascer e Crescer - Birth and Growth Medical Journal adheres to the terms of the Creative Commons License "Attribution - Non-Commercial Use (CC-BY-NC)".
It is the author's responsibility to obtain permission to reproduce figures, tables, etc. from other publications.
Authors must submit a Conflict of Interest statement and an Authorship Form with the submission of the article. An e-mail will be sent to the corresponding author confirming receipt of the manuscript.
Authors are permitted to make their articles available in repositories at their home institutions, provided that they always indicate where the articles were published and adhere to the terms of the Creative Commons license.