Relationship between acute pyelonephritis, renal scarring, and vesicoureteral reflux. Results of a coordinated research project.
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.
Orellana
Pilar
P
Nuclear Medicine Section, School of Medicine, Catholic University of Chile, Marcoleta 347, Santiago, Chile. pilar@med.puc.cl
Baquedano
Paulina
P
Rangarajan
Venkatesh
V
Zhao
Jin Hua
JH
Eng
Ng David Chee
ND
Fettich
Jurij
J
Chaiwatanarat
Tawatchi
T
Sonmezoglu
Kerim
K
Kumar
Dilip
D
Park
Yung Ha
YH
Samuel
Aban Meyer
AM
Sixt
Rune
R
Bhatnagar
Veereshwar
V
Padhy
Ajit K
AK
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000209:etiology; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D011446:Prospective Studies; D011704:Pyelonephritis / Q000209:etiology*; D051437:Renal Insufficiency / Q000453:epidemiology* / Q000209:etiology; D014552:Urinary Tract Infections / Q000150:complications*; D014718:Vesico-Ureteral Reflux / Q000150:complications*