The prevalence of kidney scarring due to urinary tract infection in Iranian children: a systematic review and meta-analysis

Najafi, Farid; Sarokhani, Diana; Dehkordi, Ali Hasanpour

doi:10.1016/j.jpurol.2019.05.011

Cited by 5 publications

(5 citation statements)

References 42 publications

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“…According to EAU/ESPU guidelines for UTIs, the presence of underlying urinary tract or kidney anatomical abnormalities is a risk factor for UTI ( 10 ). A systematic review and meta-analysis of 18 studies revealed that children with high grade of vesicoureteral reflux are prone to UTI and more likely to develop renal scars ( 11 ). However, the effect of urinary tract malformations on the bacterial composition is not well characterized.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Microbial Etiology Characteristics in Pediatric Urinary Tract Infection

Liu

Wei

et al. 2022

Front. Pediatr.

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BackgroundUrinary tract infection (UTI) is a common occurrence in children. UTI and urological malformations are intimately linked. However, whether urinary tract malformations affect the clinical features of pediatric UTI remains unclear. The purpose of this study was to characterize the clinical features and microbial etiology of UTI in children.MethodsWe retrospectively reviewed the records of 741 patients with UTI treated at the Chongqing Medical University Affiliated Children's Hospital between 2015 and 2020. Patients with and without urological malformations were compared using propensity score matching (PSM).ResultsEscherichia coli was the most common causative microorganism of UTI, accounting for 40.5% of infections. One hundred twenty-two patients (16.5%) had urological malformations. PSM identified 122 matched pairs of patients with or without urological malformations. The proportion of patients with UTI caused by atypical microorganisms was significantly higher in patients with urological malformations (P = 0.048). Children with urological malformations showed longer duration of intravenous antibiotic treatment (P = 0.010), higher cost of treatment (P < 0.001), and higher prevalence of recurrence (23.8 vs. 10.7%, P < 0.001), compared with the normal group.ConclusionChildren with urological malformations are more likely to develop UTI with atypical microorganisms. Appropriate imaging examination and urine culture are strongly recommended for the diagnosis and management of pediatric UTI.

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Section: Introductionmentioning

confidence: 99%

Clinical and Microbial Etiology Characteristics in Pediatric Urinary Tract Infection

Liu

Wei

et al. 2022

Front. Pediatr.

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“…The 20 recent articles [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] on meta-analyses were published in the JPUrol between October 9, 2017, and May 17, 2021. Of these, only seven [19][20][21][22][23][24][25] were included for the calculation of FI.…”

Section: Resultsmentioning

confidence: 99%

“…Of these, only seven [19][20][21][22][23][24][25] were included for the calculation of FI. The remaining were excluded as they incorporated non-comparative studies [6][7][8][9][10][11][12][13][14][15][16][17] and/or none of the defined methods for pooling the estimates (Mantel-Haenszel or inverse variance or Peto) were identified in them [6][7][8][9][10][11][12][13][14][15][16][17][18]. Among the seven included studies, there were 22 individual meta-analyses.…”

Section: Resultsmentioning

confidence: 99%

Fragility Index of Recently Published Meta-Analyses in Pediatric Urology: A Striking Observation

Anand¹,

Kainth²

2021

Cureus

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Background and objectiveFragility Index (FI) of meta-analyses determines their stability in terms of the level of confidence and strength behind the results depicted by them. The present study was conducted to estimate the FI of recently published meta-analyses in the Journal of Pediatric Urology (JPUrol). MethodTwenty recently published articles on meta-analyses were screened to identify the eligible ones. The baseline data of each meta-analysis including the details of the author, number of included studies, total sample size, the total number of events, the status of the overall outcome (significant or non-significant), type of effect measure, type of method used for pooling the estimates, and type of effects model were recorded. FI was calculated by doing each single status modification. The 95% CI of the treatment effect was re-calculated until the statistical significance of the meta-analysis was reversed. ResultsA total of seven articles incorporating 22 meta-analyses were included. Seven (32%) of them had a statistically significant outcome prior to FI estimation. The risk ratio (17/22; 77%) was the most commonly used effect measure. The random-effects model (15/22; 68%) and the Mantel-Haenszel method (20/22; 91%) of pooling the estimates were utilized in the majority of meta-analyses. The median (Q1-Q3; range) FI of statistically significant, non-significant, and total meta-analyses were 5 (3-19.5; 2-39), 5 (3.5-6; 1-17), and 5 (3-13; 1-39) respectively. FI of ≤5 was noticed in four out of seven (57%), 9/15 (60%), and 13/22 (59%) of these meta-analyses respectively. ConclusionBased on our findings, the majority of the recently published meta-analyses in the field of pediatric urology are fragile and depend upon the event status of ≤5 participants.

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“…The results of meta-analysis of Najafi et al in 2019 showed that the prevalence of renal scarring in Iranian children is 31% (14% in girls and 23% in boys), the prevalence of renal scarring is 47% and 12% in children with urinary reflux and in children without urinary reflux respectively (42). In this study, as in the In the meta-analysis conducted by Sheikh et al, the prevalence of renal scarring was 15.5% and 4.1% of children had some degree of urinary reflux.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of renal scaring caused by urinary tract infections in children: a systematic review and meta-analysis

et al. 2022

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PURPOSE. SOURCES OF INFORMATION. Urinary tract infection (UTI) is the second most common infection in children, the most important complication of which is renal scarring. The aim of present study was to evaluate the prevalence of renal scarring after UTI in children through systematic review and meta-analysis. METHODS. The international databases of Science Direct, PubMed, Scopus, and Web of Science and the Google Scholar search engine were searched using standard keywords. The sources found were from 2010 to 2020 and the search stage was updated until 2021.02.16. Data were analyzed using STATA-14 software and the significance level was considered at PRESULTS. In 29 studies with a sample size of 9,986 children, the prevalence of renal scarring in children was estimated at 35% (95% CI: 29-41). Also, the prevalence of renal scarring was in girls 61% (95% CI: 40-81) and in boys 34% (95% CI: 11-57). The prevalence of unilateral renal scarring in children was 56% (95% CI: 48-65) and bilateral renal scarring was 31% (95% CI: 14-48). In addition, the prevalence of scar was 54% in children with reflux and 12% in children without vesicoureteral reflux. CONCLUSIONS. More than one third of people under the age of 18 after UTI have renal scarring. The prevalence of this complication in girls is about 2 times higher than that in boys and in people with reflux, it is about 4 times higher than people who do not have urinary reflux. Also, about half of people under the age of 18 suffer from unilateral renal scarring and about one third of them suffer from bilateral renal scarring

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The prevalence of kidney scarring due to urinary tract infection in Iranian children: a systematic review and meta-analysis

Cited by 5 publications

References 42 publications

Clinical and Microbial Etiology Characteristics in Pediatric Urinary Tract Infection

Clinical and Microbial Etiology Characteristics in Pediatric Urinary Tract Infection

Fragility Index of Recently Published Meta-Analyses in Pediatric Urology: A Striking Observation

Prevalence of renal scaring caused by urinary tract infections in children: a systematic review and meta-analysis

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