Long-term consequences of urinary tract infections

Current Opinion in Pediatrics

Volumn 12, Issue 2, 2000, Pages 125-128

  Hellerstein, Stanley ^a  

^a UNIVERSITY OF MISSOURI KANSAS CITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ACUTE PYELONEPHRITIS; HUMAN; HYPERTENSION; KIDNEY DYSPLASIA; KIDNEY FUNCTION; KIDNEY HYPOPLASIA; KIDNEY INJURY; PRIORITY JOURNAL; REVIEW; URINARY TRACT INFECTION; VESICOURETERAL REFLUX;

CHILD; HUMANS; HYPERTENSION, RENAL; KIDNEY DISEASES; KIDNEY FAILURE, CHRONIC; URINARY TRACT INFECTIONS; URODYNAMICS; VESICO-URETERAL REFLUX;

EID: 0034107192     PISSN: 10408703     EISSN: None     Source Type: Journal    
DOI: 10.1097/00008480-200004000-00007     Document Type: Review

References (19)

1. 1 Sillén U: Vesicoureteral reflux in infants. Pediatr Nephrol 1999, 13:355-361. This excellent review of initial and follow-up studies in infants with intrauterine VUR was written by a premier investigator in this field. It is biased toward recognition of the importance of bladder malfunction and is worth reading.
2. 2 Sillén U, Hellström AL, Hermanson G, Abrahamson K: Comparison of urodynamic and free voiding pattern in infants with dilating reflux. J Urol 1999, 161:1928-1933. This paper reports extensive noninvasive observations and the results of video cystometry with suprapubic catheters in 33 male and 8 female infants with gross VUR. Thirty-five patients had pyelonephritis as the presenting symptom, and six were identified by prenatal ultrasonography. This report gives a taste of the in-depth studies done to obtain data to improve our understanding of the pathophysiology of the problems presented by infants with gross VUR.
3. 3 Stock JA, Wilson D, Hanna MK: Congenital reflux nephropathy and severe unilateral fetal reflux. J Urol 1998, 160:1017-1018.
4. 4 Assael BM, Guez S, Marra G, Secco E, Manzoni G, Bosio M, et al.: Congenital reflux nephropathy: a follow-up of 108 cases diagnosed perinatally. Br J Urol 1998, 82:252-257.
5. 5 Wingen A-M, Koskimies O, Olbing H, Seppänen J, Tamminen-Möbius T: Growth and weight gain in children with vesicoureteral reflux receiving medical versus surgical treatment: 10-year results of a prospective, randomized study. Acta Pediatr 1999, 88:56-61. In this 10-year follow-up study of 236 children with UTI and VUR, outcome did not differ in the medical and the surgical treatment groups. However, the data suggest that early treatment of UTI may promote normal growth.
6. 6 Jacobson SH, Iklöf O, Eriksson CG, Lins LE, Tidgren B, Winberg J: Development of hypertension and uraemia after pyelonephritis in childhood: 27-year follow-up. BMJ 1989, 16:703-706.
7. 7 Martinell J, Claesson I, Lidin-Janson G, Jodal U: Urinary infection, reflux and renal scarring in females continuously followed for 13-38 years. Pediatr Nephrol 1995, 9:131-136.
8. 8 Smellie JM, Prescod NP, Shaw PJ, Risdon RA, Bryant TN: Childhood reflux and urinary infection: a follow-up of 10-41 years in 226 adults. Pediatr Nephrol 1998, 12:727-736. This paper reports on 226 adults 18 to 37 years after they had a symptomatic UTI with VUR at 5 days to 12 years of age. Ninety percent of the adults were well and normotensive. Two patients had received kidney transplants, and one had died of renal related hypertension associated with a cerebral hemorrhage. Nine of 162 patients (5.6%) who had follow-up serum creatinine concentrations measured had elevated concentrations. Seventeen of the 226 adults (7.5%) had hypertension. This paper and others provide valuable data on the long-term prognosis of children with UTI and no obstructive lesions.
9. 9 Goonasekera CDA, Gordon I, Dillon MJ: 15-year follow-up of reflux nephropathy by imaging. Clin Nephrol 1998, 50:224-231.
10. m-DMSA renal scintigraphy in the follow-up of acute pyelonephritis in children: comparison with urographie data. Nucl Med Commun 1998, 19:703-710.
11. 11 Stokland E, Hellstrom M, Jacobsson B, Jodal U, Sixt R: Evaluation of DMSA scintigraphy and urography in assessing both acute and permanent renal damage in children. Acta Radiol 1998, 39:447-452. This study examined 157 children with first-time asymptomatic UTI who had IVU and DMSA scintigraphy at the time of the UTI and 1 year later. Renal damage was three times more frequent on scintigraphy than on IVU. The proportion of children with renal damage on IVU or scintigraphy who develop hypertension or renal failure is unknown.
12. 12 Vanderfaeillie A, Flamen P, Wilikens A, Desprechins B, Piepsz A: Technetium-99m-dimercaptosuccinic acid renal scintigraphy in children over 5 years. Pediatr Nephrol 1998, 12:295-297.
13. m DMSA renal SPECT. Clin Nucl Med 1998, 23:828-831.
14. 14 Goonasekera CDA, Dillon MJ: Hypertension in reflux nephropathy. BJU Int 1999, 83(suppl 3):1-12. This is an overall review of the causes, pathogenesis, diagnosis, and treatment of hypertension in "reflux nephropathy." The references are extensive. The term reflux nephropathy, which supplants the older term chronic atrophic pyelonephritis, covers at least three major categories of disease: acquired renal scarring secondary to UTI and VUR; congenital renal damage with dysplastic features and prenatal VUR but no UTI; and renal scarring associated with outlet obstruction. Hypertension affects at least 10% of children with renal scars.
15. 15 Hansson S: Long term outcome of urinary tract infections. Pediatr Nephrol 1998, 12:40.
16. 16 Esbjömer E, Berg U, Hansson S: Epidemiology of chronic renal failure in children: a report of Sweden 1986-1994. Pediatr Nephrol 1997, 11:438-442.
17. 17 Vallee JP, Vallee MPD, Greenfield SP, Wan J, Springate J: Contemporary incidence of morbidity related to vesicoureteral reflux. Urology 1999, 53:812-815.
18. 18 Sreenarasimhaiah S, Hellerstein S: Urinary tract infections per se do not cause end-stage kidney disease. Pediatr Nephrol 1998, 12:210-213.
19. 19 Lagomarsimo E, Valenzuela A, Cavagnaro F, Solar E: Chronic renal failure in pediatrics, 1996. Pediatr Nephrol 1999, 13:288-291.