Renal scarring following urinary tract infections in children.

Bandari, Balakrishna; Sindgikar, Seema Pavaman; Kumar, Soma Santosh; Vijaya, Mangalapady Shenoy; Shankar, Raghu

doi:10.24911/sjp.106-1554791193

Cited by 15 publications

(13 citation statements)

References 18 publications

(17 reference statements)

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“…35 In different studies, afebrile recurrent UTIs have been associated with renal scarring, at percentages of up to 38%. 36,37 In the present study, we found that 12 of the 61 patients (19.7%) with afebrile recurrent UTIs had renal scarring, and six of those patients had VUR, which is the main cause of renal scarring, consistent with the literature. Several causes of afebrile UTIs leading to renal scarring can be listed.…”

Section: Discussionsupporting

confidence: 91%

“…It is known that recurrent afebrile UTIs can also cause scar formation in the presence of congenital anomalies of the kidney and urinary tract 35 . In different studies, afebrile recurrent UTIs have been associated with renal scarring, at percentages of up to 38% 36,37 . In the present study, we found that 12 of the 61 patients (19.7%) with afebrile recurrent UTIs had renal scarring, and six of those patients had VUR, which is the main cause of renal scarring, consistent with the literature.…”

Section: Discussionsupporting

confidence: 91%

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Vitamin D deficiency as a risk factor for renal scarring in recurrent urinary tract infections

Döven¹,

Erdoğan

2021

Pediatrics International

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Background: Renal scarring is a serious complication in recurrent urinary tract infections (UTIs). Vitamin D deficiency has also been reported to be a risk factor for UTIs although, to date, no association between vitamin D deficiency and renal scarring has yet been identified. In the present study, it was investigated whether vitamin D deficiency may be a risk factor for renal scarring in patients with recurrent UTIs. Methods: The study included patients between the ages of 1 and 18 years who were admitted to the pediatric nephrology department of the center between November 1, 2018 and November 1, 2019 and who were diagnosed with recurrent UTIs. The medical records of the patients were reviewed for the collection of demographic data, vitamin D levels, ultrasonography results and scintigraphic investigations with 99m-technetium dimercaptosuccinic acid (99m Tc-DMSA). The patients were divided into two groups: those with and without renal scarring, diagnosed via 99m Tc-DMSA. The vitamin D levels and other parameters of the two groups were compared. Results: Vitamin D deficiency (<20 ng/mL) was observed in 73.9% of the patients without renal scarring, and in 94.1% of those with renal scarring (P = 0.015). A logistic regression analysis revealed vitamin D deficiency to be an independent risk factor for renal scarring in patients with recurrent UTIs (OR = 0.796 [0.691-0.917]). Conclusions: Vitamin D deficiency is found to be a risk factor for renal scarring in patients with recurrent UTIs. Vitamin D treatment may contribute to the prevention of renal scarring in patients with recurrent UTI.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Vitamin D deficiency as a risk factor for renal scarring in recurrent urinary tract infections

Döven¹,

Erdoğan

2021

Pediatrics International

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“…Providers may also be concerned about associations between recurrent UTI and renal scarring and therefore may be apt to keep neonates on IV treatment longer. 16 Additionally, those with abnormal ultrasounds may also be at risk for increased illness severity, which may lead to a longer length of stay.…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Clinical Factors and Duration of IV Antibiotic Treatment in Neonatal UTI

Marsh

Watson

Holton

et al. 2020

Hospital Pediatrics

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To describe practice patterns of intravenous (IV) antibiotic treatment duration in term neonates #28 days old with a urinary tract infection (UTI). METHODS:We performed a retrospective chart review of term neonates #28 days old hospitalized for UTI at 2 academic pediatric hospitals from 2012 to 2018. Neonates who were admitted to the PICU or with known preexisting renal and/or urologic anomalies or concomitant bacteremia were excluded. We examined clinical features, complications, and duration of IV antibiotic therapy. Univariate and multivariate analyses of long duration of IV antibiotics (.48 hours) were performed by using logistic regression. RESULTS:Of 310 neonates identified by diagnostic codes and chart review, 112 met criteria for inclusion. The median IV antibiotic duration was 49 hours (51% received IV antibiotics for .48 hours), and the median total antibiotic duration was 10 days. No demographic features or laboratory values correlated with IV antibiotic duration apart from age ,7 days. The odds of long IV antibiotic duration increased if the neonate had a secondary diagnosis extending hospitalization (adjusted odds ratio [aOR] 5 3.2; P 5 .002; 95% confidence interval [CI], 1.2-8.7), subspecialty consult (aOR 5 4.79; P , .001; 95% CI, 1.87-12.3), or an abnormal renal ultrasound (aOR 5 2.26; P 5 .02; 95% CI, 1.01-5.08). Only 1 neonate experienced treatment failure. CONCLUSIONS:Our study revealed the recent trend toward shorter IV antibiotic courses for healthy term neonates with UTI is inclusive of infants #28 days at these 2 sites. Few factors associated with neonates' initial clinical presentation appear to influence the length of IV antibiotic treatment.

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“…In a study involving 303 children with UTI who were under 2 years of age, Stokland et al showed that the risk of renal scarring was elevated in Tc-99m DMSA scintigraphy in cases with high-grade VUR [28]. In the carried out by Bandari et al, the rates of renal scarring were 33%, 33%, 40%, 50% and 80% in patients with grade I, II, III, IV and V VUR, respectively [29]. Similarly, Jaukovic et al found renal scars in 26% of the children with low-grade VUR and in 56% of the children with high-grade VUR [30].…”

Section: Discussionmentioning

confidence: 99%

Is there a relationship between renal scarring and neutrophil-to-lymphocyte ratio in patients with vesicoureteral reflux?

Demir

Yağmur

Kati

et al. 2021

Preprint

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Aim: Vesicoureteral reflux (VUR) exacerbates the risk of renal scarring by establishing a ground for pyelonephritis. It is known that the inflammatory process is more influential than the direct damage caused by bacterial infection in the development of renal scars after pyelonephritis. Therefore, the present study aims to investigate the relationship between renal scarring and systemic inflammatory markers in patients with VUR. Methods: Hundred and ninety-two patients (116 girls, 76 boys) diagnosed with VUR were divided into two groups based on the presence or absence of renal scarring and into three groups according to the grade of VUR (low, moderate and high). Neutrophil count, lymphocyte count, mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR) were compared among the groups. Results: Of the 192 patients, 102 had renal scarring. The age and gender distribution did not differ significantly between the groups with and without renal scarring (p > 0.05). However, the grade of reflux and lymphocyte count were significantly higher in the group with renal scarring (p < 0.05), and the NLR was significantly lower in the group with renal scarring (p < 0.05). The lymphocyte count was significantly higher (p <0.05) and NLR was significantly lower in the high-grade VUR group (p < 0.05). However, MPV values did not differ significantly (p > 0.05) between the groups. Conclusion: NLR can be used to predict renal scarring in patients with VUR and may even serve as a candidate marker for treatment selection. However, larger series and prospective studies are needed. Keywords: vesicoureteral reflux, neutrophil-to-lymphocyte ratio, pyelonephritis, renal scarring

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Renal scarring following urinary tract infections in children.

Cited by 15 publications

References 18 publications

Vitamin D deficiency as a risk factor for renal scarring in recurrent urinary tract infections

Vitamin D deficiency as a risk factor for renal scarring in recurrent urinary tract infections

Relationship Between Clinical Factors and Duration of IV Antibiotic Treatment in Neonatal UTI

Is there a relationship between renal scarring and neutrophil-to-lymphocyte ratio in patients with vesicoureteral reflux?

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