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Risk factors of renal scars in children with acute pyelonephritis

Fahimeh Ehsanipour1, Minoo Gharouni, Ali Hoseinpoor Rafati

  • 1Division of Infectious Diseases, Department of Pediatrics, Rasoul Akram Hospital, Tehran University of Medical Sciences, Tehran, Iran. ehsanipourfahimeh@yahoo.com

The Brazilian Journal of Infectious Diseases : an Official Publication of the Brazilian Society of Infectious Diseases
|February 24, 2012
PubMed

Insights

Recurrent pyelonephritis and vesicoureteral reflux (VUR) in children are linked to an increased risk of developing renal scars after acute kidney infections. Early identification and management of these factors are crucial for preventing kidney damage.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Radiology

Background:

  • Acute pyelonephritis is a common kidney infection in children.
  • Renal scarring can result from pyelonephritis and may lead to long-term complications.
  • Identifying risk factors for renal scarring is essential for timely intervention.

Purpose of the Study:

  • To investigate the association between known risk factors, specifically recurrent pyelonephritis and vesicoureteral reflux (VUR), and the incidence of renal scarring following acute pyelonephritis in pediatric patients.

Main Methods:

  • Prospective study involving 80 children diagnosed with acute pyelonephritis between 2007 and 2009.
  • Renal scarring was assessed using Dimercaptosuccinic acid (DMSA) scans performed 4-6 months post-infection.
  • Statistical analysis, including multivariate analysis, was employed to determine significant associations.

Main Results:

  • 55% of the children developed renal scars.
  • Renal scarring was significantly more common in cases of bilateral pyelonephritis (69.4%) and in children with a history of VUR (75%).
  • Recurrent pyelonephritis and VUR were confirmed as independent risk factors for renal scarring through multivariate analysis.

Conclusions:

  • Vesicoureteral reflux (VUR) and recurrent pyelonephritis are significant independent predictors of renal scarring in children.
  • These findings underscore the importance of evaluating for VUR and considering the history of recurrent infections in managing pediatric pyelonephritis to mitigate long-term renal damage.
Abstract

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