Korean J Pediatr.  2012 Oct;55(10):367-370. 10.3345/kjp.2012.55.10.367.

Renal scar formation after urinary tract infection in children

• Park YS

• KMID: 2140711
• DOI: http://doi.org/10.3345/kjp.2012.55.10.367

Abstract

Urinary tract infection (UTI) is a common bacterial illness in children. Acute pyelonephritis in children may lead to renal scarring with the risk of later hypertension, preeclampsia during pregnancy, proteinuria, and renal insufficiency. Until now, vesicoureteral reflux (VUR) has been considered the most important risk factor for post-UTI renal scar formation in children. VUR predisposes children with UTI to pyelonephritis, and both are associated with renal scarring. However, reflux nephropathy is not always acquired; rather, it reflects reflux-associated congenital dysplastic kidneys. The viewpoint that chronic kidney disease results from renal maldevelopment-associated VUR has led to questioning the utility of any regimen directed at identifying or treating VUR. Despite the recognition that underlying renal anomalies may be the cause of renal scarring that was previously attributed to infection, the prevention of renal scarring remains the goal of all therapies for childhood UTI. Therefore, children at high risk of renal scar formation after UTI should be treated and investigated until a large clinical study and basic research give us more information.

Keyword

Urinary tract infection; Renal scar; Vesico-ureteral reflux; Child

MeSH Terms

Child
Cicatrix
Humans
Hypertension
Kidney
Pre-Eclampsia
Pregnancy
Proteinuria
Pyelonephritis
Renal Insufficiency
Renal Insufficiency, Chronic
Risk Factors
Urinary Tract
Urinary Tract Infections
Vesico-Ureteral Reflux