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Renal function in acute febrile urinary tract infection in children: pathophysiologic aspects on the reduced

U Berg

    Kidney International
    |December 1, 1981
    PubMed

    Insights

    Acute pyelonephritis in children impairs kidney concentrating ability due to increased blood flow and reduced sodium delivery. Renal function and kidney size normalize post-infection, restoring concentrating capacity.

    Area of Science:

    • Pediatric Nephrology
    • Renal Physiology

    Background:

    • Acute pyelonephritis is associated with a reduced renal concentrating capacity.
    • The underlying mechanisms in pediatric patients require further elucidation.

    Purpose of the Study:

    • To investigate the renal functional changes, specifically concentrating capacity, in children with acute pyelonephritis.
    • To identify the factors contributing to impaired renal function during and after infection.

    Main Methods:

    • Studied 14 children (5-16 years) with acute pyelonephritis.
    • Assessed glomerular filtration rate, renal plasma flow, free water clearance, urinary sodium excretion, and maximal urine osmolality.
    • Measurements were taken during infection and within 10 months post-infection.

    Main Results:

    • Glomerular filtration rate and renal plasma flow were elevated during infection, normalizing post-infection.
    • Urinary sodium excretion, distal sodium delivery, and maximal urine osmolality were reduced during infection, improving afterward.
    • Kidney size was increased during the acute phase.

    Conclusions:

    • Reduced concentrating capacity in acute pyelonephritis may result from increased medullary blood flow (washout effect).
    • Low distal tubular sodium delivery also contributes to impaired urine concentration.
    • Renal function and concentrating ability recover after infection resolution.

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