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Isolated Hydronephrosis and Urinary Tract Infection by Two Years of Age: A Population-Based Study
Gilad Hamdani1, Noga Yaniv2, Shoval Shoham2
1Nephrology Institute, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Insights
Infants with isolated hydronephrosis (IH) face a significantly higher risk of urinary tract infections (UTI) within their first two years. This finding underscores the need for vigilant monitoring and prompt diagnosis of UTI in infants diagnosed with IH.
Area of Science:
- Pediatric Nephrology
- Urology
- Infectious Disease Epidemiology
Background:
- Urinary tract infections (UTIs) are common in infants.
- Isolated hydronephrosis (IH) is a congenital condition affecting the kidneys.
- The association between IH and UTI risk requires further investigation.
Purpose of the Study:
- To determine the risk of developing a urinary tract infection (UTI) in infants diagnosed with isolated hydronephrosis (IH).
Main Methods:
- A retrospective, population-based cohort study was conducted.
- Infants were categorized into control, IH, and complicated urological diagnosis (CUD) groups.
- The primary endpoint was UTI diagnosis within the first two years of life.
Main Results:
- Infants with IH showed a significantly higher UTI incidence (17%) compared to controls (4%).
- Both IH (OR 7.04) and CUD (OR 14.9) were independently associated with increased UTI risk.
- Male infants with IH had a higher UTI risk than female controls.
Conclusions:
- Infants with isolated hydronephrosis exhibit an elevated risk for UTIs in early childhood.
- A high index of suspicion for UTI is recommended in infants with IH.
- These findings support enhanced surveillance for UTIs in this pediatric population.
Objective:
To evaluate the risk for urinary tract infection (UTI) in infants with isolated hydronephrosis (IH).
Study Design:
A retrospective, population-based study including all infants insured by Clalit Health Services and followed from birth to age 2 years in 3 regions of central Israel. Infants were divided into 3 groups based on electronic medical record diagnoses by age 6 months: (1) control: no urological diagnosis; (2) IH; and (3) complicated urological diagnosis (CUD): any additional nephrological/urological diagnosis with/without HN. The primary outcome was a diagnosis of UTI in the first 2 years of life.
Results:
The cohort included 340 619 infants (52% male): 333 920 controls, 4369 with IH, and 2331 with CUD. Infants with IH were associated with a greater risk for UTI than control patients (17% vs 4%, P < .001). UTI risk for a male infant with IH was greater than for a female infant in the control group (12.6% vs 6.5%, P < .001). In a multivariable logistic regression analysis, both IH (OR 7.04; 95% CI 6.46-7.66) and CUD (OR 14.9; 95% CI 13.6-16.4) were independently associated with UTI.
Conclusion:
Infants with IH are at a greater risk for UTI in the first 2 years of life, supporting the recommendation for a high index of suspicion for UTI in this population.
