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Published on: June 23, 2015
Long-term consequences of urinary tract infections
1University of Missouri School of Medicine at Kansas City, Division of Pediatric Nephrology, The Children's Mercy Hospital, 64108, USA.
Current Opinion in Pediatrics
|April 14, 2000
Summary
Urinary tract infections (UTIs) in infants often lead to reassessments of kidney damage, with many cases now attributed to congenital issues rather than infection. Vesicoureteric reflux (VUR) plays a less dominant role in kidney infections than previously understood.
Area of Science:
- Pediatric Nephrology
- Urology
- Infectious Diseases
Background:
- Recent research has significantly altered the understanding of urinary tract infection (UTI) consequences in infants.
- Previously, kidney damage post-UTI was common; now, congenital renal damage is recognized more frequently.
- The role of vesicoureteric reflux (VUR) in acute pyelonephritis pathogenesis is being re-evaluated.
Purpose of the Study:
- To review the evolving understanding of consequences of urinary tract infections in infants.
- To differentiate between infection-induced and congenital renal damage.
- To assess the current importance of VUR in the context of kidney infections.
Main Methods:
- Review of recent studies on infant urinary tract anomalies and infections.
- Analysis of diagnostic criteria for congenital renal damage versus infection-related damage.
- Evaluation of the incidence of kidney infection in the presence and absence of VUR.
Main Results:
- Many infants diagnosed with post-UTI kidney damage actually have congenital renal abnormalities.
- Kidney infections frequently occur without VUR, diminishing its previously emphasized role.
- Infants with intrauterine VUR but no UTI history can exhibit impaired kidney function or hypertension due to renal hypoplasia/dysplasia.
Conclusions:
- The etiological understanding of renal damage in infants with urinary tract issues has shifted towards congenital factors.
- Vesicoureteric reflux is not as critical in acute pyelonephritis as once believed.
- Congenital renal anomalies, even without infection history, can lead to significant renal complications in infants.
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