This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (23)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Pediatrics, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

Martin Wennerström, MD; Sverker Hansson, MD, PhD; Ulf Jodal, MD, PhD; Rune Sixt, MD, PhD; Eira Stokland, MD, PhD

Arch Pediatr Adolesc Med. 2000;154:339-345.

Objective  To evaluate renal function in a population-based cohort with urographic renal scarring after childhood urinary tract infection (UTI).

Design  Follow-up investigation 16 to 26 years after the first recognized UTI.

Setting  Outpatient university clinic for children with UTI serving the local area.

Patients  From the original cohort of 1221 consecutive children with first UTI diagnosed during 1970 to 1979, 57 (41 females and 16 males; mean age, 24.5 years) of 68 with nonobstructive renal scarring participated as well as 51 (38 females and 13 males; mean age, 24.9 years) matched subjects without scarring.

Main Outcome Measure  Glomerular filtration rate (GFR) measured by chromium 51–EDTA clearance, expressed as milliliters per minute per 1.73 square meters.

Results  Median GFR was 99 in both those with and without renal scarring. In patients with unilateral scarring, the total GFR remained unchanged over the years whereas the individual GFR of the scarred kidneys declined significantly from 46 to 39. In 7 patients with bilateral scarring, the GFR declined from 94 to 84 (P=.14); compared with those with unilateral scarring, the GFR was significantly lower at follow-up (P=.007). Median urinary albumin-creatinine ratio was 1.2 and 0.6 mg/mmol in those with scarring and those without, respectively (P=.30).

Conclusions  The GFR 2 decades after the first recognized UTI in childhood was well preserved. However, a significant reduction of individual renal GFR in the unilaterally scarred kidneys indicates that further follow-up is required. Although there were few patients with bilateral scarring, a more serious prognosis can be expected among them.

From the Departments of Pediatrics (Drs Wennerström, Hansson, and Jodal), Pediatric Clinical Physiology (Dr Sixt), and Pediatric Radiology (Dr Stokland), Sahlgrenska University Hospital/East, Göteborg, Sweden.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Association Between Escherichia coli Bacteriuria and Renal Function in Women: Long-term Follow-up
Meiland et al.
Arch Intern Med 2007;167:253-257.
ABSTRACT | FULL TEXT  

Vesicoureteric reflux and urinary tract infection in children
Blumenthal
Postgrad. Med. J. 2006;82:31-35.
ABSTRACT | FULL TEXT  

The presence of vesicoureteric reflux does not identify a population at risk for renal scarring following a first urinary tract infection
Moorthy et al.
Arch. Dis. Child. 2005;90:733-736.
ABSTRACT | FULL TEXT  

Imaging guidelines for urinary tract infection in childhood; time for change?
Beattie
Arch. Dis. Child. 2004;89:398-399.
FULL TEXT  

Newborn Circumcision and Urinary Tract Infections
Bartman; et al.
Pediatrics 2001;107:210b-214.
FULL TEXT  

Long-Term Outlook in Renal Scarring from UTIs
JWatch General 2000;2000:5-5.
FULL TEXT