Long-term clinical consequences of urinary tract infections during childhood: a review


Giovanni Montini, MD, Nephrology, Dialysis Unit, Department of Pediatrics, Azienda Ospedaliera Universitaria Sant’Orsola-Malpighi Bologna, Via Massarenti 11, Padiglione 13, 40138 Bologna, Italy.
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Email: giovanni.montini@aosp.bo.it


Kidney scarring related to urinary tract infection in childhood has been considered the cause of serious long-term clinical consequences. This assumption is now debated, as the advent of routine antenatal ultrasound in the 1980s has shown that a consistent part of the changes previously attributed to postinfectious scarring is mainly due to congenital malformations. With the aim of determining what is presently known on the long-term clinical consequences of urinary tract infections (UTIs) in childhood, we performed a review of the literature on the relation between UTIs and blood pressure, renal function, growth and pregnancy-related complications. By searching Medline/PubMed and Embase from 1980 to 2011, we identified 20 cohorts of children from 23 papers.

Conclusions:  Renal function: there are no clear data to establish long-term consequences following UTIs during childhood. Most data seem to show that the outcome of renal function can already be delineated at first presentation or in the initial years of follow-up; only 0.4% of children with normal renal function at start presented a decrease during follow-up. Hypertension: there is a low risk, associated with renal damage. Growth and pregnancy-related complications: the few available data seem to exclude a major influence of UTIs.