Primary and acquired renal scarring in boys and girls with urinary tract infection☆,☆☆,★
Section snippets
METHODS
The pediatric medical care organization in Göteborg has previously been described.9 Since the early 1960s, most children with UTI in this distinct geographic area have been treated at the children’s hospital. During the late 1970s, 86% of the children with febrile UTI in the city were primarily treated at the hospital10 and followed up at a special UTI clinic, which provides continuity and uniform handling.9 In short, for all children younger than 1 year and all with febrile infections,
Primary and Acquired Renal Scarring
Seventy-four children, 21 boys and 53 girls, were found to have renal scarring. In 10 children, 4 boys and 6 girls, the scarring was bilateral. The scarring was primary, that is, seen on the first urogram, in 34. Of these, 4 boys and 2 girls initially had isolated calyceal deformity and 2 boys had isolated parenchymal thinning. Acquired scarring was found in 40 children; median time from the first UTI to detection of scarring was 3.1 years (mean, 3.7 years). Boys had primary scarring
DISCUSSION
In this study a population-based group of children, ascertained during a 10-year period, was followed after their first known UTI. Age at detection was low, with the highest rate of first febrile infections during infancy in both girls and boys,12 and the probability of previous undetected infections can be considered low. Both these factors, an unselected patient population and early detection of infections, are essential when describing development of pyelonephritic renal scarring. Because
Acknowledgements
We thank Henrik Ahlbom for advice and assistance with statistical analyses.
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Cited by (0)
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Supported by the Swedish Medical Research Council, the Skandia Life Insurance Company, the Frimurare-Barnhusdirektionen, and the Gothenburg Medical Society.
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Reprint requests: Martin Wennerström, Department of Pediatrics, Sahlgrenska University Hospital/East, S-416 85 Göteborg, Sweden.
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0022-3476/2000/$12.00 + 0 9/21/102615