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Post-pyelonephritic renal scars are not associated with vesicoureteral reflux in children

Seppo Taskinen1, Kai Rönnholm

  • 1Hospital for Children and Adolescents, Helsinki University, Helsinki, Finland. seppo.taskinen@hus.fi

The Journal of Urology
|March 11, 2005
PubMed

Insights

Renal scars in children after pyelonephritis are often caused by the infection itself, not urinary tract abnormalities. However, structural issues can lead to recurrent infections and potential kidney damage.

Area of Science:

  • Pediatric Nephrology
  • Urology
  • Infectious Diseases

Background:

  • Children with pyelonephritis face risks of renal damage.
  • Early identification of risk factors for renal scarring is crucial.

Purpose of the Study:

  • To evaluate clinical signs and urological abnormalities in predicting renal scars post-pyelonephritis in children.
  • To determine the incidence and predictors of renal scarring after a first episode of pyelonephritis.

Main Methods:

  • 64 hospitalized children with first pyelonephritis underwent ultrasonography and technetium-labeled dimercapto-succinic acid (DMSA) scintigraphy within 1 week.
  • Voiding cystourethrography was performed at 8 weeks; follow-up DMSA scintigraphy at 2 years for 58 patients.

Main Results:

  • 48% of patients showed parenchymal defects on initial DMSA.
  • Renal scars were present in 21% of patients at 2-year follow-up; most did not have vesicoureteral reflux (VUR).
  • Older age at infection correlated with renal scars; high-grade VUR with repeat infections showed kidney function deterioration.

Conclusions:

  • Renal scars after initial pyelonephritis are primarily infection-related, not due to urinary tract abnormalities.
  • Structural abnormalities can predispose to recurrent infections.
  • New renal scars can develop post-pyelonephritis in all children, irrespective of sex or age.
Abstract

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