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Childhood Urinary Tract Infection May Bring Lasting Harm to Kidneys
Date:8/5/2014

scarring, Shaikh and his colleagues reviewed existing data from previous studies involving 1,280 children aged 18 and younger.

About 15 percent of these children suffered kidney scarring from a urinary tract infection. The researchers found that three factors were strongly associated with scarring:

  • Fever of at least 102 degrees.
  • Infection with a bacteria other than E. coli.
  • Ultrasound readings that detected an abnormality in the kidney.

A model based on these factors predicted nearly 45 percent of children who ended up developing kidney scars, a rate only 3 percent to 5 percent less effective than models involving blood tests or the catheter/X-ray examination, the researchers reported.

The findings were published online Aug. 4 in the journal JAMA Pediatrics.

The test's real power comes in its ability to rule out children at risk, Shaikh noted.

"The prediction is not perfect," he said. "For more or less, we can say these 80 percent of kids aren't going to scar, we don't have to worry about them."

Doctors can step up observation of kids at greater risk for kidney scarring. "The main focus should be to prevent subsequent infections for those children," Shaikh said. "Every time you get a [urinary tract infection], you get a chance of scarring again."

Roberts agreed.

"Now that we know the groups at greatest risk, maybe we can come up with methods for decreasing inflammation during this infection and possibly preventing scars," he said. "We can back off the things we're doing that are distressing to children, and think about novel ways to preserve the kidneys of these children."

More information

Visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases for more on urinary tract infections in children.

SOURCES: Nader Shaikh, M.D., M.P.H
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