Skip to main content
Top
Published in: Pediatric Nephrology 9/2015

01-09-2015 | Original Article

Renal function in adult women with urinary tract infection in childhood

Authors: Carin Gebäck, Sverker Hansson, Jeanette Martinell, Torsten Sandberg, Rune Sixt, Ulf Jodal

Published in: Pediatric Nephrology | Issue 9/2015

Login to get access

Abstract

Background

The risk of deterioration of renal function in patients with urinary tract infection (UTI)-associated renal damage over several decades is incompletely known but of importance in regard to follow-up.

Methods

A population-based cohort of women followed from their first UTI in childhood was studied at median age of 27 years and now at 41 years. Renal damage was evaluated by 99mTc-dimercaptosuccinic acid scan and glomerular filtration rate (GFR) by 51Cr-edetic acid clearance. Extent of individual kidney damage was graded as class 1 to 3.

Results

Eighty-six women completed the investigation, 58 with renal damage, and 28 without. Of those with damage, one had chronic kidney disease (CKD) stage 3, 14 stage 2, and 43 stage 1. Women with bilateral damage had lower GFR than those with no or unilateral damage (p < 0.0001). Women with class 3 damage had numerically but not significantly lower GFR than the others with damage (p = 0.07). Between the two studies there was significant decrease of GFR in the group with bilateral damage (p = 0.01).

Conclusions

Women with UTI-associated renal damage had remarkably well preserved renal function, but those with bilateral or severe individual kidney damage may be considered for regular monitoring of GFR and blood pressure.
Literature
1.
go back to reference Shaikh N, Ewing AL, Bhatnagar S, Hoberman A (2010) Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics 126:1084–1091CrossRefPubMed Shaikh N, Ewing AL, Bhatnagar S, Hoberman A (2010) Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics 126:1084–1091CrossRefPubMed
2.
go back to reference Marild S, Jodal U (1998) Incidence rate of first-time symptomatic urinary tract infection in children under 6 years of age. Acta Paediatr 87:549–552 Marild S, Jodal U (1998) Incidence rate of first-time symptomatic urinary tract infection in children under 6 years of age. Acta Paediatr 87:549–552
3.
go back to reference Geback C, Hansson S, Himmelmann A, Sandberg T, Sixt R, Jodal U (2014) Twenty-four-hour ambulatory blood pressure in adult women with urinary tract infection in childhood. J Hypertens 32:1658–1664CrossRefPubMed Geback C, Hansson S, Himmelmann A, Sandberg T, Sixt R, Jodal U (2014) Twenty-four-hour ambulatory blood pressure in adult women with urinary tract infection in childhood. J Hypertens 32:1658–1664CrossRefPubMed
4.
go back to reference Jacobson SH, Eklof O, Eriksson CG, Lins LE, Tidgren B, Winberg J (1989) Development of hypertension and uraemia after pyelonephritis in childhood: 27-year follow-up. BMJ 299:703–706PubMedCentralCrossRefPubMed Jacobson SH, Eklof O, Eriksson CG, Lins LE, Tidgren B, Winberg J (1989) Development of hypertension and uraemia after pyelonephritis in childhood: 27-year follow-up. BMJ 299:703–706PubMedCentralCrossRefPubMed
5.
go back to reference Smellie JM, Prescod NP, Shaw PJ, Risdon RA, Bryant TN (1998) Childhood reflux and urinary infection: a follow-up of 10–41 years in 226 adults. Pediatr Nephrol 12:727–736CrossRefPubMed Smellie JM, Prescod NP, Shaw PJ, Risdon RA, Bryant TN (1998) Childhood reflux and urinary infection: a follow-up of 10–41 years in 226 adults. Pediatr Nephrol 12:727–736CrossRefPubMed
6.
go back to reference Jodal U (1987) The natural history of bacteriuria in childhood. Infect Dis Clin North Am 1:713–729PubMed Jodal U (1987) The natural history of bacteriuria in childhood. Infect Dis Clin North Am 1:713–729PubMed
7.
go back to reference Winberg J, Andersen HJ, Bergstrom T, Jacobsson B, Larson H, Lincoln K (1974) Epidemiology of symptomatic urinary tract infection in childhood. Acta Paediatr Scand Suppl 252:1–20CrossRefPubMed Winberg J, Andersen HJ, Bergstrom T, Jacobsson B, Larson H, Lincoln K (1974) Epidemiology of symptomatic urinary tract infection in childhood. Acta Paediatr Scand Suppl 252:1–20CrossRefPubMed
8.
go back to reference Martinell J, Claesson I, Lidin-Janson G, Jodal U (1995) Urinary infection, reflux and renal scarring in females continuously followed for 13–38 years. Pediatr Nephrol 9:131–136CrossRefPubMed Martinell J, Claesson I, Lidin-Janson G, Jodal U (1995) Urinary infection, reflux and renal scarring in females continuously followed for 13–38 years. Pediatr Nephrol 9:131–136CrossRefPubMed
9.
go back to reference Martinell J, Hansson S, Claesson I, Jacobsson B, Lidin-Janson G, Jodal U (2000) Detection of urographic scars in girls with pyelonephritis followed for 13–38 years. Pediatr Nephrol 14:1006–1010CrossRefPubMed Martinell J, Hansson S, Claesson I, Jacobsson B, Lidin-Janson G, Jodal U (2000) Detection of urographic scars in girls with pyelonephritis followed for 13–38 years. Pediatr Nephrol 14:1006–1010CrossRefPubMed
10.
go back to reference Martinell J, Lidin-Janson G, Jagenburg R, Sivertsson R, Claesson I, Jodal U (1996) Girls prone to urinary infections followed into adulthood. Indices of renal disease. Pediatr Nephrol 10:139–142CrossRefPubMed Martinell J, Lidin-Janson G, Jagenburg R, Sivertsson R, Claesson I, Jodal U (1996) Girls prone to urinary infections followed into adulthood. Indices of renal disease. Pediatr Nephrol 10:139–142CrossRefPubMed
11.
go back to reference Lebowitz RL, Olbing H, Parkkulainen KV, Smellie JM, Tamminen-Mobius TE (1985) International system of radiographic grading of vesicoureteric reflux. International Reflux Study in Children. Pediatr Radiol 15:105–109CrossRefPubMed Lebowitz RL, Olbing H, Parkkulainen KV, Smellie JM, Tamminen-Mobius TE (1985) International system of radiographic grading of vesicoureteric reflux. International Reflux Study in Children. Pediatr Radiol 15:105–109CrossRefPubMed
12.
go back to reference Claesson I, Jacobsson B, Olsson T, Ringertz H (1981) Assessment of renal parenchymal thickness in normal children. Acta Radiol Diagn 22:305–314CrossRef Claesson I, Jacobsson B, Olsson T, Ringertz H (1981) Assessment of renal parenchymal thickness in normal children. Acta Radiol Diagn 22:305–314CrossRef
13.
go back to reference Eklof O, Ringertz H (1976) Kidney size in children. A method of assessment. Acta Radiol Diagn 17:617–625CrossRef Eklof O, Ringertz H (1976) Kidney size in children. A method of assessment. Acta Radiol Diagn 17:617–625CrossRef
14.
go back to reference Olbing H, Claesson I, Ebel KD, Seppanen U, Smellie JM, Tamminen-Mobius T, Wikstad I (1992) Renal scars and parenchymal thinning in children with vesicoureteral reflux: a 5-year report of the International Reflux Study in Children. J Urol 148:1653–1656PubMed Olbing H, Claesson I, Ebel KD, Seppanen U, Smellie JM, Tamminen-Mobius T, Wikstad I (1992) Renal scars and parenchymal thinning in children with vesicoureteral reflux: a 5-year report of the International Reflux Study in Children. J Urol 148:1653–1656PubMed
15.
go back to reference Weiss R, Tamminen-Mobius T, Koskimies O, Olbing H, Smellie JM, Hirche H, Lax-Gross H (1992) Characteristics at entry of children with severe primary vesicoureteral reflux recruited for a multicenter, international therapeutic trial comparing medical and surgical management. The International Reflux Study in Children. J Urol 148:1644–1649PubMed Weiss R, Tamminen-Mobius T, Koskimies O, Olbing H, Smellie JM, Hirche H, Lax-Gross H (1992) Characteristics at entry of children with severe primary vesicoureteral reflux recruited for a multicenter, international therapeutic trial comparing medical and surgical management. The International Reflux Study in Children. J Urol 148:1644–1649PubMed
16.
go back to reference Hansson S, Dhamey M, Sigström O, Sixt R, Stokland E, Wennerström M, Jodal U (2004) Dimercapto-succinic acid scintigraphy instead of voiding cystourethrography for infants with urinary tract infections. J Urol 172:1071–1074CrossRefPubMed Hansson S, Dhamey M, Sigström O, Sixt R, Stokland E, Wennerström M, Jodal U (2004) Dimercapto-succinic acid scintigraphy instead of voiding cystourethrography for infants with urinary tract infections. J Urol 172:1071–1074CrossRefPubMed
17.
go back to reference Sixt R, Stokland E (1998) Assessment of infective urinary tract disorders. Q J Nucl Med 42:119–125PubMed Sixt R, Stokland E (1998) Assessment of infective urinary tract disorders. Q J Nucl Med 42:119–125PubMed
18.
go back to reference Preda I, Jodal U, Sixt R, Stokland E, Hansson S (2010) Value of ultrasound in evaluation of infants with first urinary tract infection. J Urol 183:1984–1988CrossRefPubMed Preda I, Jodal U, Sixt R, Stokland E, Hansson S (2010) Value of ultrasound in evaluation of infants with first urinary tract infection. J Urol 183:1984–1988CrossRefPubMed
19.
go back to reference Bröchner-Mortensen J (1972) A simple method for the determination of glomerular filtration rate. Scand J Clin Lab Invest 30:271–274CrossRefPubMed Bröchner-Mortensen J (1972) A simple method for the determination of glomerular filtration rate. Scand J Clin Lab Invest 30:271–274CrossRefPubMed
20.
go back to reference Foundation NK (2002) Definition and classification of stages of Chronic kidney disease. Am J Kidney Dis Suppl 39:S46CrossRef Foundation NK (2002) Definition and classification of stages of Chronic kidney disease. Am J Kidney Dis Suppl 39:S46CrossRef
21.
go back to reference Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, Boudier HA, Zanchetti A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Filippatos G, Funck-Brentano C, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Erdine S, Kiowski W, Agabiti-Rosei E, Ambrosioni E, Lindholm LH, Viigimaa M, Adamopoulos S, Bertomeu V, Clement D, Farsang C, Gaita D, Lip G, Mallion JM, Manolis AJ, Nilsson PM, O’Brien E, Ponikowski P, Redon J, Ruschitzka F, Tamargo J, van Zwieten P, Waeber B, Williams B (2007) 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 25:1105–1187CrossRefPubMed Mancia G, De Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, Boudier HA, Zanchetti A, Vahanian A, Camm J, De Caterina R, Dean V, Dickstein K, Filippatos G, Funck-Brentano C, Hellemans I, Kristensen SD, McGregor K, Sechtem U, Silber S, Tendera M, Widimsky P, Zamorano JL, Erdine S, Kiowski W, Agabiti-Rosei E, Ambrosioni E, Lindholm LH, Viigimaa M, Adamopoulos S, Bertomeu V, Clement D, Farsang C, Gaita D, Lip G, Mallion JM, Manolis AJ, Nilsson PM, O’Brien E, Ponikowski P, Redon J, Ruschitzka F, Tamargo J, van Zwieten P, Waeber B, Williams B (2007) 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 25:1105–1187CrossRefPubMed
22.
go back to reference Pylkkanen J, Vilska J, Koskimies O (1981) The value of level diagnosis of childhood urinary tract infection in predicting renal injury. Acta Paediatr Scand 70:879–883CrossRefPubMed Pylkkanen J, Vilska J, Koskimies O (1981) The value of level diagnosis of childhood urinary tract infection in predicting renal injury. Acta Paediatr Scand 70:879–883CrossRefPubMed
23.
go back to reference Grewal GS, Blake GM (2005) Reference data for 51Cr-EDTA measurements of the glomerular filtration rate derived from live kidney donors. Nucl Med Commun 26:61–65CrossRefPubMed Grewal GS, Blake GM (2005) Reference data for 51Cr-EDTA measurements of the glomerular filtration rate derived from live kidney donors. Nucl Med Commun 26:61–65CrossRefPubMed
24.
go back to reference Wennerstrom M, Hansson S, Jodal U, Sixt R, Stokland E (2000) Renal function 16 to 26 years after the first urinary tract infection in childhood. Arch Pediatr Adolesc Med 154:339–345 Wennerstrom M, Hansson S, Jodal U, Sixt R, Stokland E (2000) Renal function 16 to 26 years after the first urinary tract infection in childhood. Arch Pediatr Adolesc Med 154:339–345
25.
go back to reference Wennerstrom M, Hansson S, Jodal U, Stokland E (1998) Disappearance of vesicoureteral reflux in children. Arch Pediatr Adolesc Med 152:879–883CrossRefPubMed Wennerstrom M, Hansson S, Jodal U, Stokland E (1998) Disappearance of vesicoureteral reflux in children. Arch Pediatr Adolesc Med 152:879–883CrossRefPubMed
Metadata
Title
Renal function in adult women with urinary tract infection in childhood
Authors
Carin Gebäck
Sverker Hansson
Jeanette Martinell
Torsten Sandberg
Rune Sixt
Ulf Jodal
Publication date
01-09-2015
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 9/2015
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-015-3084-8

Other articles of this Issue 9/2015

Pediatric Nephrology 9/2015 Go to the issue