Sürmeli Döven Serra, Erdoğan Semra
Department of Paediatric Nephrology, Mersin City Education and Research Hospital, Mersin, Turkey.
Department of Biostatistics, Mersin University Faculty of Medicine, Mersin, Turkey.
Pediatr Int. 2021 Mar;63(3):295-299. doi: 10.1111/ped.14397. Epub 2021 Mar 13.
Renal scarring is a serious complication in recurrent urinary tract infections (UTIs). Vitamin D deficiency has also been reported to be a risk factor for UTIs although, to date, no association between vitamin D deficiency and renal scarring has yet been identified. In the present study, it was investigated whether vitamin D deficiency may be a risk factor for renal scarring in patients with recurrent UTIs.
The study included patients between the ages of 1 and 18 years who were admitted to the pediatric nephrology department of the center between November 1, 2018 and November 1, 2019 and who were diagnosed with recurrent UTIs. The medical records of the patients were reviewed for the collection of demographic data, vitamin D levels, ultrasonography results and scintigraphic investigations with 99m-technetium dimercaptosuccinic acid ( Tc-DMSA). The patients were divided into two groups: those with and without renal scarring, diagnosed via Tc-DMSA. The vitamin D levels and other parameters of the two groups were compared.
Vitamin D deficiency (<20 ng/mL) was observed in 73.9% of the patients without renal scarring, and in 94.1% of those with renal scarring (P = 0.015). A logistic regression analysis revealed vitamin D deficiency to be an independent risk factor for renal scarring in patients with recurrent UTIs (OR = 0.796 [0.691-0.917]).
Vitamin D deficiency is found to be a risk factor for renal scarring in patients with recurrent UTIs. Vitamin D treatment may contribute to the prevention of renal scarring in patients with recurrent UTI.
肾瘢痕形成是复发性尿路感染（UTIs）的严重并发症。维生素D缺乏也被报道为UTIs的一个危险因素，尽管迄今为止，尚未发现维生素D缺乏与肾瘢痕形成之间存在关联。在本研究中，调查了维生素D缺乏是否可能是复发性UTIs患者肾瘢痕形成的危险因素。
该研究纳入了2018年11月1日至2019年11月1日期间入住该中心儿科肾脏病科且被诊断为复发性UTIs的1至18岁患者。查阅患者的病历以收集人口统计学数据、维生素D水平、超声检查结果以及用99m锝二巯基丁二酸（Tc-DMSA）进行的闪烁显像检查结果。通过Tc-DMSA将患者分为两组：有肾瘢痕形成组和无肾瘢痕形成组。比较两组的维生素D水平和其他参数。
在无肾瘢痕形成的患者中，73.9%存在维生素D缺乏（<20 ng/mL），而在有肾瘢痕形成的患者中，这一比例为94.1%（P = 0.015）。逻辑回归分析显示，维生素D缺乏是复发性UTIs患者肾瘢痕形成的独立危险因素（OR = 0.796 [0.691 - 0.917]）。
发现维生素D缺乏是复发性UTIs患者肾瘢痕形成的危险因素。维生素D治疗可能有助于预防复发性UTI患者的肾瘢痕形成。
