Pathogenic factors in recurrent urinary tract infections and renal scar formation in children

Mannhardt, W.; Schofer, O.; Schulte-Wissermann, Hermann

doi:10.1007/bf00439233

Cited by 28 publications

(15 citation statements)

References 52 publications

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“…The results available support the assumption that the presence of VUR pre disposes to pyelonephritis, but not to recurrent UTI itself. The latter is rather influenced by other host factors such as bladder dysfunction, increased periurethral bac terial colonization and probably a defect in the antibac- terial function of the UEC [26]. In previous experiments we were able to confirm a suppression of bacterial growth by cocultivating E. coli with UEC from healthy donors [15].…”

Section: Postoperative Utisupporting

confidence: 55%

Long-Term Follow-Up of Children with Surgically Treated Yesicorenal Reflux: Postoperative Incidence of Urinary Tract Infections, Renal Scars and Arterial Hypertension

Beetz

Schulte-Wissermann²,

Tröger³

et al. 1989

Eur Urol

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Section: Postoperative Utisupporting

confidence: 55%

Long-Term Follow-Up of Children with Surgically Treated Yesicorenal Reflux: Postoperative Incidence of Urinary Tract Infections, Renal Scars and Arterial Hypertension

Beetz

Schulte-Wissermann²,

Tröger³

et al. 1989

Eur Urol

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“…Regardless of whether RPDs are primary or secondary, they are a major risk factor for progressive CKD [2,3,14,15]. Owing to the severity of the potential poor outcome, it has been generally accepted that children with RPDs should be followed for several years, regardless of when and why they had been detected.…”

Section: Introductionmentioning

confidence: 99%

“…The association between urinary tract infection (UTI), vesicoureteral reflux (VUR) and renal parenchymal defects (RPDs)-scars, hypoplasia/dysplasia-was believed to be well established [1][2][3]. The long-held belief that VUR can lead to progressive chronic kidney disease (CKD) has been increasingly questioned, and a new viewpoint has emerged, namely, that CKD results from primary renal scarring or renal maldevelopment (hypoplasia, dysplasia), while VUR is only a sign of abnormal renal development and most probably not an important risk factor for renal scarring [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Sensitivity of ultrasonography in detecting renal parenchymal defects: 6 years’ follow-up

et al. 2009

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While (99m)Tc-dimercaptosuccinic acid (DMSA) scanning is still considered the most accurate method for the assessment of renal parenchymal defects (RPDs), our study 6 years previously suggested that ultrasonography (US) could be a safe and efficient substitute for this purpose, provided that it is reliably performed and that renal function parameters are followed. By comparison of the original and follow-up study data from 67 children, the accuracy of our recommendations was re-evaluated. US was performed and renal function parameters investigated and correlated to the DMSA scans from the original study. US identified all six patients with clinically significant RPD and 52/61 with clinically insignificant RPDs, seen on the DMSA scans. Twenty two out of 22 severe RPDs, 21/23 moderate RPDs and 20/40 mild RPDs seen on the DMSA scans were detected by US. In ten cases normal US findings from the original study were rendered abnormal, correlating well with the DMSA scans with respect to RPD localization and kidney size. These results further support our previous suggestion that US is a safe and harmless alternative to DMSA scanning in the detection and follow-up of RPDs. While it cannot be excluded that small RPDs missed on the initial US might 'develop' clinical significance in later life, children with normal findings on initial US should have another sonogram done, at the shortest a year later, together with an investigation of renal function parameters.

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“…In recent decades, a significant change in the management of children after UTI has occurred. It was long believed that vesicoureteric reflux (VUR) of infected urine or even sterile VUR of high grade per se can lead to renal scarring and progressive chronic kidney disease (38)(39)(40). Lately, however, such a role of VUR has been questioned by many authors (41)(42)(43)(44)(45)(46)(47)(48)(49)(50).…”

Section: Management Of Children After Urinary Tract Infectionmentioning

confidence: 99%

Urinary Tract Infection in Children – Onset of a New Era?

Levart¹,

Kenda²

2011

Urinary Tract Infections

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Pathogenic factors in recurrent urinary tract infections and renal scar formation in children

Cited by 28 publications

References 52 publications

Long-Term Follow-Up of Children with Surgically Treated Yesicorenal Reflux: Postoperative Incidence of Urinary Tract Infections, Renal Scars and Arterial Hypertension

Long-Term Follow-Up of Children with Surgically Treated Yesicorenal Reflux: Postoperative Incidence of Urinary Tract Infections, Renal Scars and Arterial Hypertension

Sensitivity of ultrasonography in detecting renal parenchymal defects: 6 years’ follow-up

Urinary Tract Infection in Children – Onset of a New Era?

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