Marks Stephen D, Gordon Isky, Tullus Kjell
Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK.
Pediatr Nephrol. 2008 Jan;23(1):9-17. doi: 10.1007/s00467-007-0552-9. Epub 2007 Aug 1.
The correct protocol for investigating urinary tract infections (UTI) is unknown but remains a hotly debated topic. The main objective in investigating children with UTI is to prevent the long-term complications of developing hypertension, chronic kidney disease (CKD) and/or pregnancy complications. However, the prognosis for childhood UTI remains good, with low long-term risks, from epidemiological studies, of developing these sequelae. Although childhood UTI is common, the occurrence of CKD and the likelihood that acute pyelonephritis will cause renal damage progressing to CKD are rare. We studied the current literature on investigations of childhood UTI and propose a protocol for carrying out selected investigations in high-risk children. By identifying this group of children with increased risk of having an abnormal urinary tract that warrant investigation, we recommend that targeting investigations to specific children (as opposed to protocol-based investigations of all children with UTI), will be clinically safe and effective and will avoid the unnecessary distress and cost of invasive investigations.
目前，尚不清楚用于调查尿路感染（UTI）的正确方案，这仍是一个备受争议的热门话题。对患有UTI的儿童进行调查的主要目的是预防发展为高血压、慢性肾脏病（CKD）和/或妊娠并发症等长期并发症。然而，从流行病学研究来看，儿童UTI的预后仍然良好，发生这些后遗症的长期风险较低。虽然儿童UTI很常见，但CKD的发生以及急性肾盂肾炎导致肾损害进而发展为CKD的可能性很小。我们研究了有关儿童UTI调查的当前文献，并提出了一项针对高危儿童进行特定检查的方案。通过识别出这组尿路异常风险增加且需要进行调查的儿童，我们建议针对特定儿童进行检查（而不是对所有UTI儿童进行基于方案的检查）在临床上是安全有效的，并且可以避免侵入性检查带来的不必要痛苦和费用。
