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[Risk factors for permanent kidney damage in children with urinary tract infection]
Pilar Orellana1, Felipe Cavagnaro, Paulina Baquedano
1Departamentos de Radiología, Pediatría, Urología, Laboratorio de Medicina Nuclear, Salud Pública, Hospital Clínico, Facultad de Medicina, Pontificia Universidad Católica de Chile. pilar@med.puc.cl
Insights
Urinary tract infections (UTI) in children can lead to permanent kidney damage. Key risk factors include vesicoureteral reflux, recurrent infections, and older age, highlighting the need for prompt diagnosis and management.
Area of Science:
- Pediatric Nephrology
- Infectious Diseases
Background:
- Urinary tract infection (UTI) is a prevalent childhood illness with the potential to cause irreversible kidney damage.
- Early identification of risk factors is crucial for preventing long-term complications in pediatric UTI cases.
Purpose of the Study:
- To identify specific risk factors associated with permanent kidney damage in children diagnosed with UTI.
- To evaluate the impact of vesicoureteral reflux, infection recurrence, and age on renal outcomes.
Main Methods:
- A cohort of 337 children with UTI underwent static renal scintigraphy to assess for permanent kidney damage.
- Data collected included patient demographics, history of vesicoureteral reflux, and the number of UTI episodes.
Main Results:
- Permanent kidney damage was identified in 48% of the children studied.
- Vesicoureteral reflux significantly increased the risk (63% vs. 27%), as did recurrent infections (47% vs. 36%) and older age (58% in >5 years old).
- No significant gender-based differences in damage were observed.
Conclusions:
- Vesicoureteral reflux, recurrent urinary tract infections, and advanced age are significant predictors of permanent renal damage in children.
- These findings underscore the importance of early detection and intervention for pediatric UTIs, particularly in high-risk groups.
Background:
In children, urinary tract infection (UTI) is a very common disease, and can cause permanent kidney damage.
Aim:
To determine risk factors for permanent kidney damage, in children with UTI.
Patients And Methods:
In 337 children with UTI (237 female, mean age 4.2 years) a static renal scintigraphy was performed to assess the presence of permanent kidney damage. The history of vesicoureteral reflux and number of episodes of UTI was obtained.
Results:
One hundred three children had a history of one episode of infection and the rest had recurrent infections. Permanent kidney damage was observed in 161 children (48%). This damage was observed in 39% of children of less than one year of age, in 43% of children aged 1 to 5 years of age and in 58% of children older than 5 years (p = 0.02). Sixty three percent of 122 children with vesicoureteral reflux had permanent kidney damage, compared with 27% of children without this condition (p < 0.001). Likewise, damage was observed in 36% of children with one episode of infection and 47% of children with recurrent infections (p < 0.01). No gender differences were observed.
Conclusions:
Vesicoureteral reflux, recurrence of UTI and age are associated with permanent renal damage in children with UTI.