Pregnancies in women with and without renal scarring after urinary infections in childhood

Martinell, Jeanette; Jodal, Ulf; Lidin-Janson, G

doi:10.1016/0020-7292(91)90555-j

Cited by 19 publications

(43 citation statements)

References 3 publications

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“…Martinell et al [30], studying 65 pregnancies in 41 women with a history of UTI in childhood, noted a higher incidence of UTI and acute febrile infection in those with renal scarring and with persistent reflux than in controls. This is in keeping with our findings that both UTI and raised blood pressure occurred more frequently in women with renal scarring.…”

Section: Discussionmentioning

confidence: 97%

Childhood reflux and urinary infection: a follow-up of 10-41 years in 226 adults

Smellie

Prescod

Shaw

et al. 1998

Pediatric Nephrology

269

161

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To ascertain the outcome of childhood vesicoureteric reflux (VUR), 226 adults (37 males), mean age 27 years, were studied after 10-35 years, extended to 41 years by postal questionnaire in 161. At presentation (mean age 5 years) all had VUR (grade III-V in 68) and urinary tract infection (UTI); there was renal scarring in 85 (acquired before referral in 11 and during follow-up in 1), hypertension in 6 and impaired renal function in 5. They were managed and followed prospectively by one paediatrician; 63% of these children remained free from UTI; VUR persisted in 63 and had resolved in 69% of 193 children managed medically. At follow-up, 61% of adults had remained free from infection; 17 adults had hypertension and/or raised plasma creatinine, 16 with scarred kidneys. Their deterioration was predictable because of scar type, blood pressure or plasma creatinine levels in childhood. No new scars developed after puberty. Renal growth rates were unaffected by initial severity or persistence of VUR. On the later questionnaire, 9 further adults, mean age 38 years, had moderate hypertension. The adults with complications were those with extensive renal scarring and/or at least borderline hypertension in childhood. Those with VUR, but no scarring, and managed carefully in childhood, did not suffer serious consequences as adults. There is a need for early recognition and treatment of children with VUR and UTI to limit scar development.

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Section: Discussionmentioning

confidence: 97%

Childhood reflux and urinary infection: a follow-up of 10-41 years in 226 adults

Smellie

Prescod

Shaw

et al. 1998

Pediatric Nephrology

269

161

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“…The largest series, of 111 women from 1975 to 1983, with a history of previous UTI was studied in Sweden [39]. Although there was an increased incidence of bacteriuria during first pregnancies in women with childhood UTI, there was no significant difference in the incidence of preeclampsia, operative delivery, prematurity or birth weight between controls and those with and without renal scarring.…”

Section: Pregnancy-related Complicationsmentioning

confidence: 99%

Imaging in childhood urinary tract infections: time to reduce investigations

2008

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The correct protocol for investigating urinary tract infections (UTI) is unknown but remains a hotly debated topic. The main objective in investigating children with UTI is to prevent the long-term complications of developing hypertension, chronic kidney disease (CKD) and/or pregnancy complications. However, the prognosis for childhood UTI remains good, with low long-term risks, from epidemiological studies, of developing these sequelae. Although childhood UTI is common, the occurrence of CKD and the likelihood that acute pyelonephritis will cause renal damage progressing to CKD are rare. We studied the current literature on investigations of childhood UTI and propose a protocol for carrying out selected investigations in high-risk children. By identifying this group of children with increased risk of having an abnormal urinary tract that warrant investigation, we recommend that targeting investigations to specific children (as opposed to protocol-based investigations of all children with UTI), will be clinically safe and effective and will avoid the unnecessary distress and cost of invasive investigations.

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“…A retrospectvie study of pregnancies in women with renal scarring revealed that the incidence of bacteriuria and pyelonephritis in such cases was higher than that in controls [17]. Mean blood pressure was also significantly higher among women with severe renal scarring.…”

Section: The Case For Screening: Prevention Of Reflux Nephropathymentioning

confidence: 99%

Non-invasive screening for vesicoureteric reflux: a realistic aim?

Thomas

1992

World J Urol

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Pregnancies in women with and without renal scarring after urinary infections in childhood

Cited by 19 publications

References 3 publications

Childhood reflux and urinary infection: a follow-up of 10-41 years in 226 adults

Childhood reflux and urinary infection: a follow-up of 10-41 years in 226 adults

Imaging in childhood urinary tract infections: time to reduce investigations

Non-invasive screening for vesicoureteric reflux: a realistic aim?

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