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Intrarenal Injection of Escherichia coli in a Rat Model of Pyelonephritis
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Corticosteroids to prevent renal scarring in children with pyelonephritis: a systematic review and meta-analysis

Johanna Jääskeläinen1, Marjo Renko2,3, Ilari Kuitunen2,4

  • 1Institute of Clinical Medicine and Department of Pediatrics, University of Eastern Finland, Yliopistonranta 2, 70211, Kuopio, Finland. johajaa@student.uef.fi.

Journal of Nephrology
|January 24, 2023
PubMed

Insights

Corticosteroid treatment, when combined with antibiotics, may prevent kidney scarring in children with acute pyelonephritis. Further research is needed to confirm effectiveness and safety.

Area of Science:

  • Pediatric Nephrology
  • Infectious Diseases
  • Pharmacology

Background:

  • Acute pyelonephritis is a common pediatric infection.
  • It can lead to significant renal scarring.
  • Preventing renal scarring is crucial for long-term kidney health in children.

Approach:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Searched major databases (PubMed, Scopus, Cochrane, Web of Science).
  • Included studies comparing corticosteroid + antibiotics vs. antibiotics alone or with placebo.

Key Points:

  • Moderate quality evidence suggests corticosteroids reduce renal scarring risk (RR 0.65, NNT 8).
  • Renal scarring occurred in 14.1% with corticosteroids vs. 27.3% in controls.
  • Risk of bias was a concern in four of five included studies.

Conclusions:

  • Adjuvant corticosteroid therapy shows potential in preventing renal scarring in pediatric pyelonephritis.
  • More research is required to fully understand the effectiveness and safety profile.
  • Current evidence suggests potential benefit, but caution is advised due to reporting limitations.
Abstract

Keywords:
CorticosteroidsPyelonephritisRenal scars

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