Relationship between acute pyelonephritis, renal scarring, and vesicoureteral reflux

• DOI: 10.1007/s00467-004-1501-5
• Publication Date: 2004-07-15T17:27:26Z
• Authors: Pilar Orellana; Paulina Baquedano; Venkatesh Rangarajan; JinHua Zhao; NgDavidChee Eng; Jurij Fettich; Tawatchi Chaiwata...; Kerim Sonmezoglu; Dilip Kumar; YungHa Park; AbanMeyer Samuel; Rune Sixt; Veereshwar Bhatnagar; AjitK. Padhy
• Keywords: Male; Adolescent; acute pyelonephritis; 610; CHILDREN; ACID SCAN; 618; Cicatrix; 03 medical and health sciences; URINARY-TRACT-INFECTION; 0302 clinical medicine; renal scintigraphy; 03 Salud y bienestar; Humans; Prospective Studies; Renal Insufficiency; Child; Demography; DAMAGE; RISK; Vesico-Ureteral Reflux; Pyelonephritis; Incidence; Infant; vesicoureteral reflux; renal scarring; 3. Good health; Child, Preschool; Acute Disease; Urinary Tract Infections; 03 Good Health and Well-being; Female; SCINTIGRAPHY

Acute pyelonephritis (APN) may produce permanent renal damage (PRD), which can subsequently lead to diverse complications. We prospectively evaluated 147 females and 122 males (mean age 3.5 years) with APN in order to analyze the relationship between the presence of PRD, at the time of cortical renal scintigraphy, and age, gender, episodes of urinary tract infection (UTI), and presence of vesicoureteral reflux (VUR). There were 152 children studied after the first proven UTI. VUR was present in 150 children. PRD was observed in 170 children. There were no significant differences between boys and girls. PRD was found in 36.4% of children younger than 1 year and in 70.1% of those older than 1 year ( P<0.0001). Of children with VUR, 72% had PRD compared with 52% of children without VUR ( P<0.0001). Of children with a first episode of UTI, 55.9% developed PRD as did 72.6% of those with recurrent UTI ( P=0.004). Our results showed that PRD in children with APN is important, especially in the presence of VUR, recurrent UTI, and older age.