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Renal function in adult women with urinary tract infection in childhood

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Abstract

Background

The risk of deterioration of renal function in patients with urinary tract infection (UTI)-associated renal damage over several decades is incompletely known but of importance in regard to follow-up.

Methods

A population-based cohort of women followed from their first UTI in childhood was studied at median age of 27 years and now at 41 years. Renal damage was evaluated by 99mTc-dimercaptosuccinic acid scan and glomerular filtration rate (GFR) by 51Cr-edetic acid clearance. Extent of individual kidney damage was graded as class 1 to 3.

Results

Eighty-six women completed the investigation, 58 with renal damage, and 28 without. Of those with damage, one had chronic kidney disease (CKD) stage 3, 14 stage 2, and 43 stage 1. Women with bilateral damage had lower GFR than those with no or unilateral damage (p < 0.0001). Women with class 3 damage had numerically but not significantly lower GFR than the others with damage (p = 0.07). Between the two studies there was significant decrease of GFR in the group with bilateral damage (p = 0.01).

Conclusions

Women with UTI-associated renal damage had remarkably well preserved renal function, but those with bilateral or severe individual kidney damage may be considered for regular monitoring of GFR and blood pressure.

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Abbreviations

ABPM:

Ambulatory blood pressure monitoring

CKD:

Chronic kidney disease

CI:

Confidence interval

DMSA:

99mTc-dimercaptosuccinic acid

EDTA:

51Cr-edetic acid

GFR:

Glomerular filtration rate

LS:

Least square

MCUG:

Micturating cystourethrogram

SDS:

Standard deviation score

UTI:

Urinary tract infection

VUR:

Vesicoureteric reflux

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Acknowledgments

We thank Marie Magnusson for help with GFR measurements and Aldina Pivodic for assistance with statistical calculations. Financial support was provided by grants from the West Region, Sweden and the Gothenburg Medical Society.

Funding

Financial support was provided by grants from the West Region, Sweden and the Gothenburg Medical Society.

Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Göteborg, Sweden

    Carin Gebäck, Sverker Hansson, Jeanette Martinell & Ulf Jodal

  2. Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden

    Carin Gebäck & Torsten Sandberg

  3. Pediatric Clinical Physiology, Institute of Clinical Sciences, Sahlgrenska Academy, Göteborg, Sweden

    Rune Sixt

  4. Clinical Microbiology, Sahlgrenska University Hospital, SE-402 34, Göteborg, Sweden

    Carin Gebäck

Authors
  1. Carin Gebäck
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  2. Sverker Hansson
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  3. Jeanette Martinell
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  4. Torsten Sandberg
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  5. Rune Sixt
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  6. Ulf Jodal
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Corresponding author

Correspondence to Carin Gebäck.

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Gebäck, C., Hansson, S., Martinell, J. et al. Renal function in adult women with urinary tract infection in childhood. Pediatr Nephrol 30, 1493–1499 (2015). https://doi.org/10.1007/s00467-015-3084-8

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  • DOI: https://doi.org/10.1007/s00467-015-3084-8

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