Primary and acquired renal scarring in boys and girls with urinary tract infection

Wennerström, Martin; Hansson, Sverker; Jodal, Ulf; Stokland, Eira

doi:10.1016/s0022-3476(00)90045-3

Cited by 207 publications

(101 citation statements)

References 23 publications

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“…1 UTIs cause short-term morbidity such as fever, dysuria, and pain and may also result in permanent kidney scarring. [2][3][4][5] Many factors, such as age, gender, race, and circumcision status, are believed to increase the risk of recurrent UTI, [6][7][8] but over the last few decades, no factor has received more attention than vesicoureteral reflux (VUR). In this condition, which occurs in 30% to 40% of children who have had a UTI, 9 urine flows backward toward the kidneys during bladder contraction.…”

Section: What This Study Addsmentioning

confidence: 99%

Risk Factors for Recurrent Urinary Tract Infection and Renal Scarring

et al. 2015

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OBJECTIVES: To identify risk factors for recurrent urinary tract infection (UTI) and renal scarring in children who have had 1 or 2 febrile or symptomatic UTIs and received no antimicrobial prophylaxis.METHODS: This 2-year, multisite prospective cohort study included 305 children aged 2 to 71 months with vesicoureteral reflux (VUR) receiving placebo in the RIVUR (Randomized Intervention for Vesicoureteral Reflux) study and 195 children with no VUR observed in the CUTIE (Careful Urinary Tract Infection Evaluation) study. Primary exposure was presence of VUR; secondary exposures included bladder and bowel dysfunction (BBD), age, and race. Outcomes were recurrent febrile or symptomatic urinary tract infection ( F/S UTI) and renal scarring.RESULTS: Children with VUR had higher 2-year rates of recurrent F/S UTI (Kaplan-Meier estimate 25.4% compared with 17.3% for VUR and no VUR, respectively). Other factors associated with recurrent CONCLUSIONS: VUR and BBD are risk factors for recurrent UTI, especially when they appear in combination. Strategies for preventing recurrent UTI include antimicrobial prophylaxis and treatment of BBD. WHAT'S KNOWN ON THIS SUBJECT:Vesicoureteral reflux is recognized as an important risk factor for recurrent urinary tract infection and renal scarring. Less is known about the contribution of other risk factors to these outcomes. WHAT THIS STUDY ADDS:This study found that information about vesicoureteral reflux and bladder and bowel dysfunction can be used to identify children at low, medium, and high risk of recurrent urinary tract infection, information that clinicians could use to select children for specific preventive therapies.

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Section: What This Study Addsmentioning

confidence: 99%

Risk Factors for Recurrent Urinary Tract Infection and Renal Scarring

et al. 2015

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“…This can undermine their practice of anal hygiene, predisposing the female child to recurrent UTI and possible renal scarring. 9,27 In addition, there was inadequate perception of appropriate UTI therapies in children in this study. This could result from their ignorance of the disease entity and widespread self-medication practices in the setting.…”

mentioning

confidence: 78%

“…4,6 Recurrent UTI can cause acute kidney injury (AKI) and bilateral renal scarring especially among children with co-morbidities. [7][8][9][10] In a two-hit hypothesis model, this acquired renal insults confer further risk of end-stage renal disease (ESRD) especially in persons of African descent with an underlying genetic predisposition like the Apolipoprotein 1 (APOL 1) gene polymorphism. 11,12 Therefore, adequate awareness of the disorder will enhance parental health-seeking behaviour.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of parental perception of childhood urinary tract infection in Ondo, Southwestern Nigeria

Abiodun¹,

Oluwafemi²

2017

Nig. J. Paed.

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Abstract:Background: Urinary tract infection (UTI) is common in children with possible severe complications, deserving public health interventions. Aims: To evaluate parental perception of symptoms, causes, complication and treatment of childhood UTI, and proposerelevant interventions. Methods: This is an ethicallyapproved cross-sectional study using a structured questionnaire comprising a 35-item Likert-like scale on perception of UTI in children with a reliability rating of 0.93. Adequate perception of each variable was defined as mean score ≥ 3.0. Weighted mean scores were tested for significant difference using F-test. Multiple logistic regressions identified possible predictors of adequate perception among the participants. P -value <0.05 was considered significant. Results: Altogether, 600 guardians/parents took part in the study.Their mean age was 29.8±6.5 years and almost two-thirds of them (62.3%) were females. Only 18.3% of the participants had adequate perception of UTI in children. Their grand mean score on perception of UTI was 2.68 ± 0.52. There was an upward trend in weighted mean scores of the various subscales (F-test = 21.63, p=0.000). Significant predictors of adequate perception of UTI in this survey include female gender (OR=16.72; 95% CI: 5.77-48.43), Hausa ethnicity (OR= 0.02; 95% CI: 0.00-0.17) and polygamous family structure (OR= 2.40; 95% CI: 1.16-4.96). Conclusion: There was low parental perception of UTI in children in our study setting. Regular health education on childhood urinary tract disorders is recommended.

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“…A strong correlation between renal scarring and recurrent UTIs exists in children [115]. Although the developing kidney appears to be very susceptible to damage, and this susceptibility appears to be age dependent, in adult kidneys, renal scarring induced by UTIs is rare.…”

Section: Clinical Presentationmentioning

confidence: 99%