Department of Pediatrics, Institute of Clinical Medicine, Faculty of Medicine, University of Oulu, Oulu, Finland.
Pediatrics. 2011 Nov;128(5):840-7. doi: 10.1542/peds.2010-3520. Epub 2011 Oct 10.
Urinary tract infections (UTIs) in childhood are considered a risk for chronic kidney disease (CKD), but this association is poorly verified. We wanted to determine the etiologic fraction of UTIs in childhood as a cause of CKD.
A systematic literature search on the association between childhood UTIs and CKD was conducted, and data for patients with CKD in the area of 1 tertiary care hospital were reviewed.
In our literature search, we found no patients among the 1576 reviewed cases for whom childhood UTIs were the main cause of subsequent CKD. However, there were 3 patients with childhood UTIs for whom the results of kidney imaging studies were not reported. Of the 366 patients with CKD who were monitored in the Oulu University Hospital, 308 had a specific noninfectious cause of CKD. Of the remaining 58 patients, 13 had a history of UTIs in childhood. In their first imaging studies, all of those 13 patients demonstrated kidney tissue abnormalities, which could have been observed through ultrasonography. Recurrent UTIs in childhood were possibly the cause of CKD in 1 case; therefore, the etiologic fraction of recurrent childhood UTIs as a main cause of CKD was, at most, 0.3%.
In the absence of structural kidney abnormalities evident in imaging studies after the first childhood UTI, the etiologic fraction of recurrent childhood UTIs as a main cause of CKD seems to be small. A child with normal kidneys is not at significant risk of developing CKD because of UTIs.
儿童尿路感染（UTI）被认为是慢性肾脏病（CKD）的危险因素，但这种关联尚未得到充分证实。我们旨在确定儿童 UTI 在多大程度上可归因于 CKD。
对儿童 UTI 与 CKD 之间的关联进行了系统的文献检索，并对 1 家三级保健医院 CKD 患者的数据进行了回顾。
在我们的文献检索中，在所审查的 1576 例病例中，没有发现 UTI 是随后发生 CKD 的主要原因的患者。然而，有 3 例儿童 UTI 患者的肾脏影像学研究结果未报告。在奥卢大学医院监测的 366 例 CKD 患者中，有 308 例有明确的非传染性 CKD 病因。在其余 58 例患者中，有 13 例有儿童时期 UTI 病史。在他们的首次影像学研究中，这 13 例患者均显示肾脏组织异常，这可以通过超声检查观察到。1 例儿童时期反复发作的 UTI 可能是 CKD 的病因，因此，反复发作的儿童 UTI 作为 CKD 的主要病因的病因分数最多为 0.3%。
在首次儿童 UTI 后影像学检查未发现结构性肾脏异常的情况下，反复发作的儿童 UTI 作为 CKD 主要病因的病因分数似乎很小。肾脏正常的儿童因 UTI 而发展为 CKD 的风险不大。
