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[Renal scarring in children under 36 months hospitalised for acute pyelonephritis]

Begoña Rodríguez Azor1, José Miguel Ramos Fernández2, Sonia Sánchiz Cárdenas1

  • 1Unidad de Gestión Clínica de Pediatría, Hospital Materno-Infantil, Hospital Regional Universitario de Málaga, Málaga, España.

Anales De Pediatria (Barcelona, Spain : 2003)
|May 21, 2016
PubMed

Insights

Nearly half of young children hospitalized for acute pyelonephritis (APN) develop renal scarring. This scarring is linked to reinfection and severe vesicoureteral reflux (VUR), not specific bacteria or inflammatory markers.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Medical Imaging

Background:

  • Acute pyelonephritis (APN) is a common serious bacterial infection in infants.
  • Renal scarring is the most frequent long-term complication following APN.

Purpose of the Study:

  • To determine the incidence of renal scarring within six months after APN in children under 36 months.
  • To investigate the relationship between scarring and imaging studies, clinical factors, and bacteriology.

Main Methods:

  • Retrospective analysis of 125 children (1-36 months) with a first APN episode and 6-month follow-up.
  • Data collected included demographics, clinical variables, bacteriology, renal ultrasound, voiding cystourethrography (VCUG), and DMSA-scintigraphy.

Main Results:

  • Renal scarring was identified in 44.3% of patients who underwent DMSA-scintigraphy.
  • Severe vesicoureteral reflux (VUR) (grade iv-v) was observed in 32.9% of patients undergoing VCUG.
  • Scarring was associated with reinfection events and high-grade VUR, but not with specific pathogens or inflammatory markers.

Conclusions:

  • Approximately 44% of hospitalized children aged 1-36 months with APN exhibit renal scarring at six months.
  • Reinfection and high-grade VUR are significant risk factors for renal scarring post-APN.
  • Imaging findings, particularly VUR, are crucial in assessing the risk of renal scarring.
Abstract

Keywords:
Cicatriz renalCistourografía miccional seriadaDMSA-scintigraphyGammagrafía DMSAPielonefritisPyelonephritisRenal scarVoiding cystourethrography

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