Abstract

Objective: Urinary tract infection in children may be associated with renal damage. In literature, there are reports that present the existence of lesions at high rates in renal scintigraphy, which is performed four to six months after the febrile urinary tract infection. However, the recent data about the changes in these lesions over time is very limited. In this study, we aimed to analyse the changes in renal damage over time in young children with urinary tract infection and the factors related with the progression of renal damage.

Material and Methods: In this study, we retrospectively evaluated 143 patients, who were 1–24 months of age and detected to have renal damage via technetium-99m dimercaptosuccinic acid scintigraphy, which was performed at least 90 days after the first febrile urinary tract infection diagnosis, and who had follow-up scintigraphy after 2 years.

Results: Among the 143 children, who were found to have renal damage on DMSA scintigraphy, 78 (54.5%) patients remained unchanged while 27 (18.8%) showed progression and 38 (26.5%) showed regression in findings. There were no differences between groups in terms of gender or age. In the group with progression in renal damage, 21/27 (77.8%) children had grades IV–V vesicoureteral reflux and 22 (81.5%) had recurrent urinary tract infection. Multivariate regression analysis revealed that recurrent urinary tract infection is an independent risk factor for progression of renal damage. In the group with regression in renal damage, only 3/38 (7.9%) patients had vesicoureteral reflux with grades IV–V and 4/38 (10.5%) had recurrent urinary tract infection.

Conclusion: Renal damage does not occur in most small children with febrile urinary tract infection. When it does occur, the majority remain unchanged or regress over time. On the other hand, up to one-fourth of children, in whom renal damage was detected after urinary tract infection, are at risk of renal deterioration. Recurrent urinary tract infection is an independent risk factor for progression in renal damage. In these children, the probability of detecting underlying high-grade vesicoureteral reflux is extremely high. Long-term follow-up of these patients is crucial to evaluate the degree of renal damage.

Keywords: Urinary tract infection, Renal damage, Vesicoureteral reflux, Renal scintigraphy

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Copyright © 2019 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Kargın Çakıcı E. Evaluation of the Changes in Renal Damage Over Time in Children Aged 1–24 Months with Urinary Tract Infection. Turk J Pediatr Dis [Internet]. 2019 Dec. 23 [cited 2025 Aug. 23];13(6):418-23. Available from: https://turkjpediatrdis.org/article/view/550