Role of vitamin A in preventing renal scarring after acute pyelonephritis

Reza Dalirani1, Mojtaba Yousefi Zoshk, Mostafa Sharifian

  • 1Pediatric Infectious Research Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. rdalirani@yahoo.com

Insights

Vitamin A supplementation alongside antibiotics significantly reduced kidney scarring in children with acute pyelonephritis. This finding suggests vitamin A is beneficial in managing this pediatric kidney infection.

Area of Science:

  • Pediatric Nephrology
  • Nutritional Science
  • Infectious Diseases

Background:

  • Vitamin A's role in mucosal healing is established.
  • Acute pyelonephritis can lead to renal scarring in children.
  • Preventing renal scarring is crucial for long-term kidney health.

Purpose of the Study:

  • To investigate the efficacy of vitamin A in preventing renal scarring post-acute pyelonephritis in children.
  • To compare renal scarring outcomes in children treated with antibiotics plus vitamin A versus antibiotics alone.

Main Methods:

  • A randomized clinical trial involving children diagnosed with acute pyelonephritis.
  • Patients received either ceftriaxone with vitamin A or ceftriaxone alone.
  • Dimercaptosuccinic acid (DMSA) renal scintigraphy was used to assess renal scarring before and 6 months after treatment.

Main Results:

  • Seventy-six children (mean age 25 months) were enrolled; 71.1% were under 2 years old.
  • Baseline DMSA scans showed no significant difference in scarring between groups (P = .53).
  • Post-treatment DMSA scans revealed significantly less renal injury progression and scarring in the vitamin A plus antibiotic group compared to the antibiotic-only group (P < .001).

Conclusions:

  • Vitamin A administration is effective in reducing kidney injury and scarring following acute pyelonephritis in children.
  • Vitamin A can be a valuable adjunct therapy in managing pediatric acute pyelonephritis.
  • This study supports the use of vitamin A in conjunction with antibiotics for improved outcomes in children with pyelonephritis.
Abstract

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