title: Childhood urinary tract infections as a cause of chronic kidney disease.
abstract: OBJECTIVE
  Urinary tract infections (UTIs) in childhood are considered a risk for chronic kidney disease (CKD), but this association is poorly verified. We wanted to determine the etiologic fraction of UTIs in childhood as a cause of CKD.
  
  
  METHODS
  A systematic literature search on the association between childhood UTIs and CKD was conducted, and data for patients with CKD in the area of 1 tertiary care hospital were reviewed.
  
  
  RESULTS
  In our literature search, we found no patients among the 1576 reviewed cases for whom childhood UTIs were the main cause of subsequent CKD. However, there were 3 patients with childhood UTIs for whom the results of kidney imaging studies were not reported. Of the 366 patients with CKD who were monitored in the Oulu University Hospital, 308 had a specific noninfectious cause of CKD. Of the remaining 58 patients, 13 had a history of UTIs in childhood. In their first imaging studies, all of those 13 patients demonstrated kidney tissue abnormalities, which could have been observed through ultrasonography. Recurrent UTIs in childhood were possibly the cause of CKD in 1 case; therefore, the etiologic fraction of recurrent childhood UTIs as a main cause of CKD was, at most, 0.3%.
  
  
  CONCLUSIONS
  In the absence of structural kidney abnormalities evident in imaging studies after the first childhood UTI, the etiologic fraction of recurrent childhood UTIs as a main cause of CKD seems to be small. A child with normal kidneys is not at significant risk of developing CKD because of UTIs.
authors: Department of Pediatrics, Institute of Clinical Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland. jarmo.salo@oulu.fi
authors: Jarmo
authors: J
authors: Salo
authors: Risto
authors: R
authors: Ikäheimo
authors: Terhi
authors: T
authors: Tapiainen
authors: Matti
authors: M
authors: Uhari
mesh_terms: D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D007677:Kidney Function Tests; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D011379:Prognosis; D012008:Recurrence; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy