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Renal function in adult women with urinary tract infection in childhood
Carin Gebäck1, Sverker Hansson, Jeanette Martinell
1Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Göteborg, Sweden, carin.geback@vgregion.se.
Insights
Urinary tract infection (UTI)-associated renal damage in women shows well-preserved kidney function over decades. However, bilateral or severe damage warrants regular monitoring of glomerular filtration rate (GFR) and blood pressure.
Area of Science:
- Nephrology
- Urology
- Pediatric Nephrology
Background:
- Long-term renal function deterioration risk in urinary tract infection (UTI)-associated renal damage is not fully understood.
- Understanding this risk is crucial for effective patient follow-up strategies.
- This study investigates the long-term renal outcomes in women with a history of UTI-associated renal damage.
Purpose of the Study:
- To assess the long-term renal function in women with childhood UTI-associated renal damage.
- To evaluate the progression of renal damage and its impact on glomerular filtration rate (GFR) over several decades.
- To identify risk factors for renal function decline in this cohort.
Main Methods:
- A population-based cohort of women with a history of UTI since childhood was followed up.
- Renal damage was assessed using (99m)Tc-dimercaptosuccinic acid scans.
- Glomerular filtration rate (GFR) was measured using (51)Cr-edetic acid clearance at median ages of 27 and 41 years.
Main Results:
- Eighty-six women completed the study; 58 had renal damage, 28 did not.
- Among women with renal damage, 1 had chronic kidney disease (CKD) stage 3, 14 had stage 2, and 43 had stage 1.
- Women with bilateral renal damage showed a significant decrease in GFR over time (p=0.01), unlike those with unilateral or no damage.
Conclusions:
- Women with UTI-associated renal damage generally maintain well-preserved renal function.
- Individuals with bilateral or severe (class 3) kidney damage are at higher risk for GFR decline.
- Regular monitoring of GFR and blood pressure is recommended for women with bilateral or severe UTI-associated renal damage.
Background:
The risk of deterioration of renal function in patients with urinary tract infection (UTI)-associated renal damage over several decades is incompletely known but of importance in regard to follow-up.
Methods:
A population-based cohort of women followed from their first UTI in childhood was studied at median age of 27 years and now at 41 years. Renal damage was evaluated by (99m)Tc-dimercaptosuccinic acid scan and glomerular filtration rate (GFR) by (51)Cr-edetic acid clearance. Extent of individual kidney damage was graded as class 1 to 3.
Results:
Eighty-six women completed the investigation, 58 with renal damage, and 28 without. Of those with damage, one had chronic kidney disease (CKD) stage 3, 14 stage 2, and 43 stage 1. Women with bilateral damage had lower GFR than those with no or unilateral damage (p < 0.0001). Women with class 3 damage had numerically but not significantly lower GFR than the others with damage (p = 0.07). Between the two studies there was significant decrease of GFR in the group with bilateral damage (p = 0.01).
Conclusions:
Women with UTI-associated renal damage had remarkably well preserved renal function, but those with bilateral or severe individual kidney damage may be considered for regular monitoring of GFR and blood pressure.
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