Girls prone to urinary infections followed into adulthood. Indices of renal disease

Martinell, Jeanette; Lidin-Janson, G; Jagenburg, Rudolf; Sivertsson, Ramon; Claësson, I.; Jodal, Ulf

doi:10.1007/bf00862054

Cited by 76 publications

(44 citation statements)

References 17 publications

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“…In the Parker and Kunin [5] study, hypertension was noted at follow-up in only ∼15% of the women. A recent study of women with scarring visible on renal scan also confirmed that the incidences of renal insufficiency and hypertension were lower than had previously been reported [13].…”

Section: Discussionsupporting

confidence: 60%

Long-Term Follow-Up of Women Hospitalized for Acute Pyelonephritis

Raz

Sakran

Chazan

et al. 2003

Clinical Infectious Diseases

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Long-term outcome of acute pyelonephritis (AP) in adults is unknown. We evaluated the frequency of renal damage 10-20 years after hospitalization for AP in adult women and the utility of technetium Tc 99m-labeled dimercaptosuccinic acid (Tc 99m-DMSA) scanning for detection of renal scars; 63 of 203 women hospitalized with AP during 1982-1992 were included in the study. Tc 99m-DMSA scanning detected renal scarring in 29 women (46%). Multivariate analysis showed that pregnancy and hypoalbuminemia (albumin level, <3.2 g/dL) at hospitalization were independent risk factors for subsequent development of renal scars. At follow-up, hypertension was observed in approximately one-fifth of patients, regardless of renal scarring status. Four women with scars had a glomerular filtration rate of < or =75 mL/min; none of them developed severe renal impairment. In conclusion, the risk of developing renal scarring after AP in adult women is high. However, clinically relevant renal damage is rare 10-20 years after AP. Tc 99m-DMSA scanning is useful for detecting renal scars in adults but is not routinely needed in practice.

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Section: Discussionsupporting

confidence: 60%

Long-Term Follow-Up of Women Hospitalized for Acute Pyelonephritis

Raz

Sakran

Chazan

et al. 2003

Clinical Infectious Diseases

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“…Of the adults in our follow-up study, only 6% presented under the age of 1 year compared with 78% of those in a recent Gothenburg study; the long-term outcome for these children will be of considerable importance[41]. They also report a good outcome, even in those with renal scarring, of a group of 111 women followed for a mean of 15 years from their first UTI in childhood[42].The study reported here indicates that the adult outcome for children with VUR carefully managed in childhood was very good in the great majority, even when VUR persisted at the end of childhood. Deterioration of renal function or blood pressure occurred almost exclusively in those with renal scarring and was usually predictable in childhood.…”

mentioning

confidence: 66%

Childhood reflux and urinary infection: a follow-up of 10-41 years in 226 adults

Smellie

Prescod

Shaw

et al. 1998

Pediatric Nephrology

272

161

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To ascertain the outcome of childhood vesicoureteric reflux (VUR), 226 adults (37 males), mean age 27 years, were studied after 10-35 years, extended to 41 years by postal questionnaire in 161. At presentation (mean age 5 years) all had VUR (grade III-V in 68) and urinary tract infection (UTI); there was renal scarring in 85 (acquired before referral in 11 and during follow-up in 1), hypertension in 6 and impaired renal function in 5. They were managed and followed prospectively by one paediatrician; 63% of these children remained free from UTI; VUR persisted in 63 and had resolved in 69% of 193 children managed medically. At follow-up, 61% of adults had remained free from infection; 17 adults had hypertension and/or raised plasma creatinine, 16 with scarred kidneys. Their deterioration was predictable because of scar type, blood pressure or plasma creatinine levels in childhood. No new scars developed after puberty. Renal growth rates were unaffected by initial severity or persistence of VUR. On the later questionnaire, 9 further adults, mean age 38 years, had moderate hypertension. The adults with complications were those with extensive renal scarring and/or at least borderline hypertension in childhood. Those with VUR, but no scarring, and managed carefully in childhood, did not suffer serious consequences as adults. There is a need for early recognition and treatment of children with VUR and UTI to limit scar development.

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“…In one study, the incidence of CRI in 30 adults who were diagnosed with severe renal scarring as children was 10% [42]. Another study of 294 patients (mean age at presentation, 17.2 years) with reflux nephropathy found a 2% incidence of CRI (glomerular filtration rate [GFR] < 40-69 mL/min) at presentation that increased to 24% at last follow-up (mean age, 34.2 years).…”

Section: Renal Insufficiencymentioning

confidence: 94%

Urinary tract infections in children

Sedberry-Ross

Pohl²

2008

Curr Urol Rep

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Urinary tract infections can be a significant source of morbidity in the pediatric population. The mainstay of evaluating urinary tract infections in children has been physical examination, urinalysis and culture, and renal and bladder sonography and contrast cystography. However, novel clinical paradigms now consider the importance of various risk factors, such as bacterial virulence and antibiotic-resistance patterns, elimination disorders, and the role of innate immunity and inflammation in determining the likelihood of renal cortical scarring.

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Girls prone to urinary infections followed into adulthood. Indices of renal disease

Cited by 76 publications

References 17 publications

Long-Term Follow-Up of Women Hospitalized for Acute Pyelonephritis

Long-Term Follow-Up of Women Hospitalized for Acute Pyelonephritis

Childhood reflux and urinary infection: a follow-up of 10-41 years in 226 adults

Urinary tract infections in children

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