Vesicoureteral Reflux and Renal Scarring Risk in Children after the First Febrile Urinary Tract Infection

Yılmaz, Songül; Özçakar, Z. Bı̇rsı̇n; Şükür, Eda Didem Kurt; Bulum, Burcu; Kavaz, Aslı; Elhan, Atilla Halil; Yalçınkaya, Fatoş

doi:10.1159/000443536

Cited by 20 publications

(23 citation statements)

References 21 publications

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“…Hydronephrosis was the most common ultrasound finding, whereas bladder cystitis, which is of pathophysiologic importance, was found significantly more common in patients with the recurrent episode. In line with our findings, Yilmaz et al [11] reported that recurrent urinary tract infections were significantly more common in patients with renal scarring and structural abnormalities. The authors reported that the rate of recurrent infection was as high as 55%, and the presence of an ultrasound abnormality was 41.2% in children older than five years.…”

Section: Discussionsupporting

confidence: 93%

Comparison of Primary and Recurrent Urinary Tract Infections in Children

Doğan

İpek

2020

Cureus

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We aimed to compare the demographic and ultrasound data regarding first-episode urinary tract infections with recurrent infections in children. Methods A total of 509 children aged 0-16 years who were diagnosed to have a urinary tract infection (UTI) as confirmed with positive urinary culture tests were retrospectively investigated. A comparison of baseline parameters, responsible pathogen incidences, and ultrasound findings was made between children who had a single episode of UTI (n=418, 82.1%) with those having second or more recurrent episodes of urinary tract infection (n=91, 17.9%). Results The mean age of children with a single episode of urinary tract infection was significantly lower than those who had recurrent urinary tract infection (5.33±4.38 vs. 7.01±4.83 years, p=0.003). Incidences of Escherichia coli and Enterococcus faecalis was significantly higher in patients with recurrent urinary tract infection than those who had single episode (n=315, 75.4% vs. n=80, 87.9%, p=0.009 and n=8, 1.9% vs. n=9, 9.9%, p<0.001, respectively). An abnormal ultrasound was significantly more common in patients with recurrent urinary tract infection than those who had a single episode (n=41, 54.6% vs. n=59, 22.7%). Increased renal parenchymal echogenicity (p=0.002), bladder cystitis (p=0.01) and hydronephrosis (p<0.001) were significantly more common in patients with recurrent urinary tract infection than those who had a single episode of urinary tract infection. Conclusion Escherichia coli and Enterococcus faecalis were the most common responsible pathogens in recurrent urinary tract infections. Structural changes, such as hydronephrosis and bladder cystitis, are likely to have an important role in the etiology of children with recurrent urinary tract infection.

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Section: Discussionsupporting

confidence: 93%

Comparison of Primary and Recurrent Urinary Tract Infections in Children

Doğan

İpek

2020

Cureus

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“…One should suspect urinary tract anatomic abnormalities including vesicoureteral reflux if recurrent infections start in infancy in either gender (1,2). Children of all ages with urinary instrumentation or a urinary catheter are prone to iatrogenic UTIs as these procedures or instruments facilitate bacterial entry into the bladder.…”

Section: Introductionmentioning

confidence: 99%

Management of urinary tract infections in children in an era of increasing antimicrobial resistance

Robinson

Saux

2016

Expert Review of Anti-infective Therapy

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The article reviews indications for and interpretation of urinalysis and urine culture results for diagnosis of UTI, choice of antibiotics for empiric and definitive UTI therapy, the rationale behind and indications for radiographic investigations, and prevention of UTIs including the complex decision as to whether antibiotic prophylaxis will benefit a child. Expert commentary: Over-diagnosis of UTI is a prevalent problem due to the lack of specificity of both urinalysis and urine culture. The most major recent advance in the field has been the recognition that antibiotic prophylaxis for UTI is rarely indicated as in most situations, the number needed to treat to prevent one UTI is too high to justify the risk of adverse events and development of antimicrobial resistance.

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“…Renal scar was identified in half of patients (57%) who had experienced UTI and had DMSA performed. It is higher when compared to results of a study carried out in normal Turkish society (20). This situation can probably be associated with increased expression of a number of genes coding transcriptional factors as a result of interactions of calcium oxalate monohydrate crystals with epithelial cells, extracellular matrix regulators and growth factors (21).…”

Section: Discussionmentioning

confidence: 72%

Clinical Features of Cases Followed with Idiopathic Hypercalciuria in Childhood, Long-term Follow-up Results and Retrospective Evaluation of Complications

Köker¹,

Bayram²,

Soylu³

et al. 2020

meandros

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Bu çalışmada idiyopatik hiperkalsiüri (İH) tanısı ile izlenen çocuk hastaların klinik, laboratuvar, görüntüleme bulgularının, tedavi şekillerinin ve uzun süreli sonuçlarının değerlendirilmesi amaçlanmıştır. Objective: The objective of this study is to assess clinical, laboratory and imaging findings, treatment styles and long-term outcomes of paediatric patients followed with idiopathic hypercalciuria (IH). Materials and Methods: We retrospectively evaluated and reviewed the files of patients aged between 3 months and 18 years with respect to age at the time of diagnosis, gender, admission complaints, follow-up period, laboratory and imaging findings (routine urinary analysis, blood and urinary biochemistry, parathormone, vitamin D level, urinary system ultrasonography and bone mineral density), onset and follow-up anthropometric data and complications. Results: The average ages of male and female patients (total: 52) diagnosed with IH were 30 and 22 years, respectively. The follow-up periods of male and female patients were 44.5±40.8 and 22.5±3.2 (6-96) months. The most frequent admission complaints were abdominal pain and underlying urinary tract infection (UTI) and history of haematuria. The average calcium level at the time of admission was 6.56±2.65 mg/kg/day, and the average calcium/creatinine level was 0.85±0.68 mg/mg. Kidney stones were determined in 41 (79%) patients. In total, 21 (40%) patients had UTI. During follow-up, UTI developed in 6 (11.5%) of them. Following medical treatment and/or nutrition recommendations, there was a reduction in the frequency of UTI rate, haematuria and enuresis (10/11 vs 6/25, p=0.030; 8/8 vs 3/33, p=0.001; and vs 1/46, p<0.001, respectively). Conclusion: Children with IH can apply with different clinical pictures and their conditions can lead to complications such as kidney stones, UTI. However, hypercalciuria, clinical complaints and complications can regress thanks to medical treatment or nutrition recommendations.

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Vesicoureteral Reflux and Renal Scarring Risk in Children after the First Febrile Urinary Tract Infection

Cited by 20 publications

References 21 publications

Comparison of Primary and Recurrent Urinary Tract Infections in Children

Comparison of Primary and Recurrent Urinary Tract Infections in Children

Management of urinary tract infections in children in an era of increasing antimicrobial resistance

Clinical Features of Cases Followed with Idiopathic Hypercalciuria in Childhood, Long-term Follow-up Results and Retrospective Evaluation of Complications

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