Risk Factors For Urinary Tract Infection In Children With Prenatal Renal Pelvic Dilatation

Main Category: Urology / Nephrology
Also Included In: Infectious Diseases / Bacteria / Viruses;  Pediatrics / Children's Health
Article Date: 08 Mar 2008 - 0:00 PST

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UroToday.com- A study out of Brazil addressed a question that has come up quite extensively in pediatric urology, which children are at risk for a urinary tract infection that present at infancy a history of fetal renal pelvic dilation?

The group studied a total of 192 patients were diagnosed with isolated renal pelvic dilatation between 1999 and 2006. They were followed prospectively. After the initial clinical visit and evaluation there were 6-month interval follow ups for clinical examination and laboratory reviews. The end point of the study was episodes of febrile urinary tract infection. A survival analysis was performed to identify variables significantly associated with that particular event.

A significant uropathic diagnosis was found in 41% of the patients. During the follow-up urinary tract infection occurred in 14% of the patients. The median follow-up was 24 months.

By their survival analysis the cumulative incidents of urinary tract infection for the whole series was estimated to be 8% at 1 year of age, 13% at 2 year of age, and 21% at 3 year of age. The group also found that after adjustment both being a girl and the presence of any uropathy were positive independent predictors of urinary tract infection during their follow up.

From this study the group concluded that of the group of patients, the ones that are most at risk for urinary tract infections are girls with vesicoureteral reflux or urinary obstruction with a history of prenatal hydronephrosis. The strength of this prospective analysis is that they should be able to follow these patients further on a prospective basis to see if potty training plays any role in increased infection or if the children become infection free after good bladder management is instituted and constipation is kept under control.

Coelhoa GM, Bouzadaa MCF, Lemosa GS, Pereiraa AK, Limaa BP, Oliveira EA.

J Urol. 179(1): 284-289, January 2008
doi: 10.1016/j.juro.2007.08.159

Reported by UroToday.com Medical Editor Pasquale Casale, MD Assistant Professor, University of Pennsylvania University of Pennsylvania, Children's Hospital of Philadelphia

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