title: Update on childhood urinary tract infection and vesicoureteral reflux.
abstract: Urinary tract infection (UTI) is a leading cause of serious bacterial infection in young children. Vesicoureteral reflux (VUR), a common pediatric urologic disorder, is believed to predispose to UTI, and both are associated with renal scarring. The complex interaction of bacterial virulence factors and host defense mechanisms influence renal damage. However, some renal parenchymal abnormalities associated with VUR are noninfectious in origin. Long-term, renal parenchymal injury may be associated with hypertension, pregnancy complications, proteinuria, and renal insufficiency. Optimal management of VUR and UTI is controversial because of the paucity of appropriate randomized controlled trials; there is a need for well-designed studies. The recently launched Randomized Intervention for children with VesicoUreteral Reflux (RIVUR) study hopefully will provide insight into the role of antimicrobial prophylaxis of UTI in children with VUR.
authors.affiliation: Department of Pediatrics, Division of Pediatric Nephrology, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Lorraine E
authors.initials: LE
authors.lastname: Bell
authors.forename: Tej K
authors.initials: TK
authors.lastname: Mattoo
mesh_terms: D019072:Antibiotic Prophylaxis / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic; D016032:Randomized Controlled Trials as Topic; D014552:Urinary Tract Infections / Q000150:complications* / Q000188:drug therapy* / Q000209:etiology; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000188:drug therapy* / Q000209:etiology