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American Academy of Pediatrics
Article

Childhood Urinary Tract Infections as a Cause of Chronic Kidney Disease

Jarmo Salo, Risto Ikäheimo, Terhi Tapiainen and Matti Uhari
Pediatrics November 2011, 128 (5) 840-847; DOI: https://doi.org/10.1542/peds.2010-3520
Jarmo Salo
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Risto Ikäheimo
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Terhi Tapiainen
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Matti Uhari
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Abstract

OBJECTIVE: Urinary tract infections (UTIs) in childhood are considered a risk for chronic kidney disease (CKD), but this association is poorly verified. We wanted to determine the etiologic fraction of UTIs in childhood as a cause of CKD.

METHODS: A systematic literature search on the association between childhood UTIs and CKD was conducted, and data for patients with CKD in the area of 1 tertiary care hospital were reviewed.

RESULTS: In our literature search, we found no patients among the 1576 reviewed cases for whom childhood UTIs were the main cause of subsequent CKD. However, there were 3 patients with childhood UTIs for whom the results of kidney imaging studies were not reported. Of the 366 patients with CKD who were monitored in the Oulu University Hospital, 308 had a specific noninfectious cause of CKD. Of the remaining 58 patients, 13 had a history of UTIs in childhood. In their first imaging studies, all of those 13 patients demonstrated kidney tissue abnormalities, which could have been observed through ultrasonography. Recurrent UTIs in childhood were possibly the cause of CKD in 1 case; therefore, the etiologic fraction of recurrent childhood UTIs as a main cause of CKD was, at most, 0.3%.

CONCLUSIONS: In the absence of structural kidney abnormalities evident in imaging studies after the first childhood UTI, the etiologic fraction of recurrent childhood UTIs as a main cause of CKD seems to be small. A child with normal kidneys is not at significant risk of developing CKD because of UTIs.

  • chronic kidney disease
  • urinary tract infections
  • vesicoureteral reflux
  • children
  • Accepted June 30, 2011.
  • Copyright © 2011 by the American Academy of Pediatrics

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Pediatrics
Vol. 128, Issue 5
1 Nov 2011
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Childhood Urinary Tract Infections as a Cause of Chronic Kidney Disease
Jarmo Salo, Risto Ikäheimo, Terhi Tapiainen, Matti Uhari
Pediatrics Nov 2011, 128 (5) 840-847; DOI: 10.1542/peds.2010-3520

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Childhood Urinary Tract Infections as a Cause of Chronic Kidney Disease
Jarmo Salo, Risto Ikäheimo, Terhi Tapiainen, Matti Uhari
Pediatrics Nov 2011, 128 (5) 840-847; DOI: 10.1542/peds.2010-3520
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  • Childhood Urinary Tract Infections and Pregnancy-Related Complications in Adult Women
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  • Avoidance of Voiding Cystourethrography in Infants With Urinary Tract Infection
  • Reaffirmation of AAP Clinical Practice Guideline: The Diagnosis and Management of the Initial Urinary Tract Infection in Febrile Infants and Young Children 2-24 Months of Age
  • Current primary care management of children aged 1-36 months with urinary tract infections in Europe: large scale survey of paediatric practice
  • 2011 AAP UTI guideline reaffirmed after review of new data
  • Different Guidelines for Imaging After First UTI in Febrile Infants: Yield, Cost, and Radiation
  • Counterpoint: * Call for more data on diagnosing, treating first UTI in febrile children welcomed
  • Response to the AAP Section on Urology Concerns About the AAP Urinary Tract Infection Guideline
  • More Evidence Favoring Fewer VCUGs in Young Children With 1st UTI
  • Denominators Do Matter: It's a Myth--Urinary Tract Infection Does Not Cause Chronic Kidney Disease
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