Advertisement

European Journal of Pediatrics

, Volume 170, Issue 3, pp 347–350 | Cite as

The effect of vitamin A on renal damage following acute pyelonephritis in children

  • Parviz AyaziEmail author
  • Seyed Alireza Moshiri
  • Abolfazl Mahyar
  • Mona Moradi
Original Paper

Abstract

Animal studies suggest that administration of vitamin A to rats with experimental urinary tract infection decreases the frequency of renal scars (Kavukçu et al., BJU Int 83(9):1055–1059, 1999). The aim of this study was to determine the effect of vitamin A on the rate of permanent renal damage in children with acute pyelonephritis. Fifty children, median age of 24 months (range 2–144), with first-time pyelonephritis verified by an uptake defect on acute dimercaptosuccinic acid (DMSA) scan were included in the study and randomly allocated to the case or control groups. All were given intravenous ceftriaxone for 10 days followed by oral cephalexin for 3 months. Cases in addition were given a single intramuscular dose of vitamin A, 25,000 U for infants below 1 year of age and 50,000 U for older children. At the repeat DMSA scan after 3 months, five of 25 cases (20%) and 17 of 25 controls (68%) had abnormal findings (p = 0.001). In conclusion, administration of vitamin A was associated with a significantly lower rate of permanent renal damage.

Keywords

Acute pyelonephritis Children Renal scar Vitamin A 

Notes

Acknowledgment

We would like to thank our colleagues including Dr. A Barikani, Dr. N Esmailzadehha, Ms. J Pourrezaei, and the staff of the Center for Clinical Researches at Qazvin Children Hospital, affiliated to Qazvin University of Medical Sciences. Our appreciation also goes to Dr. A.A Pahlevan for his cooperation. This research was officially registered as project No. 718 at the College of Medicine, Qazvin University of Medical Sciences.

Conflict of interest

There is no conflict of interest (we did not have any financial relationship).

References

  1. 1.
    Ayazi P, Mahyar A, Jahani Hashemi H et al (2009) Comparison of procalcitonin and C-reactive protein tests in children with urinary tract infection. Iran J Pediatr 19(4):381–386Google Scholar
  2. 2.
    Bahat E, Yilmaz GG, Akman S et al (1998) Effect of vitamin A supplementation on recurrent urinary tract infections in children (abstract). Pediatr Nephrol 12:C 129Google Scholar
  3. 3.
    Bennett RT, Mazzaccaro RJ, Chopra N et al (1999) Suppression of renal inflammation with vitamins A and E in ascending pyelonephritis in rats. J Urol 161(5):1681–1684PubMedCrossRefGoogle Scholar
  4. 4.
    Bloch CE (1924) Further clinical investigations into the diseases arising in consequence of a deficiency in the fat-soluble A factor. Am J Dis Child 28(6):659–667Google Scholar
  5. 5.
    Bouissou F, Munzer C, Decramer S et al (2008) Prospective randomized trial comparing short and long intravenous antibiotics treatment of acute pyelonephritis in children: dimercaptosuccinic acid scintigraphic evaluation at 9 months. Pediatrics 121(3):e553–e560PubMedCrossRefGoogle Scholar
  6. 6.
    Brown KH, Gaffar A, Alamgir SM (1979) Xerophthalmia, protein–calorie malnutrition, and infections in children. J Pediatr 95(4):651–656PubMedCrossRefGoogle Scholar
  7. 7.
    Cho SJ, Lee SJ (2002) ACE gene polymorphism and renal scar in children with acute pyelonephritis. Pediatr Nephrol 17(7):491–495PubMedCrossRefGoogle Scholar
  8. 8.
    Editorial (1990) Vitamin A and malnutrition/infection complex in developing countries. Lancet 336(8727):1349–1351CrossRefGoogle Scholar
  9. 9.
    Haraoka M, Matsumoto T, Takahashi K et al (1994) Suppression of renal scarring by prednisolone combined with ciprofloxacin in ascending pyelonephritis in rats. J Urol 151(4):1078–1080PubMedGoogle Scholar
  10. 10.
    Haraoka M, Matsumoto T, Mizunoe Y, Takahashi K, Kubo S, Koikawa Y, Tanaka M, Sakamoto Y, Sakumoto M, Nagafuji T (1995) Effect of ebselen on renal scarring in rats following renal infection. Chemotherapy 41(3):208–213PubMedCrossRefGoogle Scholar
  11. 11.
    Imamoğlu M, Cay A, Cobanoglu U et al (2006) Effects of melatonin on suppression of renal scarring in experimental model of pyelonephritis. Urology 67(6):1315–1319PubMedCrossRefGoogle Scholar
  12. 12.
    Jakobsson B, Berg U, Svensson L (1994) Renal scaring after acute pyelonephritis. Arch Dis Child 70(2):111–115PubMedCrossRefGoogle Scholar
  13. 13.
    Kavukçu S, Türkmen M, Sevinç N et al (1998) Serum vitamin A and β-carotene concentrations and renal scarring in urinary tract infections. Arch Dis Child 78(3):271–272PubMedCrossRefGoogle Scholar
  14. 14.
    Kavukçu S, Soylu A, Türkmen M et al (1999) The role of vitamin A in preventing renal scarring secondary to pyelonephritis. BJU Int 83(9):1055–1059PubMedCrossRefGoogle Scholar
  15. 15.
    Kavukcu S, Turkmen MA, Soylu A (2001) Could the effective mechanisms of retinoids on nephrogenesis be also operative on the amelioration of injury in acquired renal lesions? Pediatr Nephrol 16(8):689–690PubMedCrossRefGoogle Scholar
  16. 16.
    Kjolhede CL, Chew FJ, Gadomski AM, Marroquin DP (1995) Clinical trial of vitamin A as adjuvant treatment for lower respiratory tract infections. J Pediatr 126(5 Pt 1):807–812PubMedGoogle Scholar
  17. 17.
    LeBrun M, Grenier L, Gourde P et al (1999) Effectiveness, and toxicity of gentamicin in an experimental model of pyelonephritis: effect of the time of administration. Antimicrob Agents Chemother 43(5):1020–1026PubMedGoogle Scholar
  18. 18.
    Roberts JA, Kaack MB, Baskin G (1990) Treatment of experimental pyelonephritis in the monkey. J Urol 143(1):150–154PubMedGoogle Scholar
  19. 19.
    Kliegman RM, Behrman RE, Jenson HB, Stanton BF (2007) Nelson textbook of pediatrics, 18th edn. Saunders, Philadelphia, pp 2223–2228Google Scholar
  20. 20.
    Sadeghi Z, Kajbafzadeh AM, Tajik P et al (2008) Vitamin E administration at the onset of fever prevents renal scarring in acute pyelonephritis. Pediatr Nephrol 23(9):1503–1510PubMedCrossRefGoogle Scholar
  21. 21.
    Sharifian M, Anvaripour N, Karimi A et al (2008) The role of dexamethasone on decreasing urinary cytokines in children with acute pyelonephritis. Pediatr Nephrol 23(9):1511–1516PubMedCrossRefGoogle Scholar
  22. 22.
    Soylu A, Kavukçu S, Sarioğlu S et al (2001) The effect of vitamin A on the course of renal ablation nephropathy. Pediatr Nephrol 16(6):472–476PubMedCrossRefGoogle Scholar
  23. 23.
    Stansfield SK, Pierre-Louis M, Lerebours G, Augustin A (1993) Vitamin A supplementation and increased prevalence of childhood diarrhea and acute respiratory infections. Lancet 342(8871):578–582PubMedCrossRefGoogle Scholar
  24. 24.
    Yagmurlu A, Boleken ME, Etory D et al (2003) Preventive effect of pentoxifylline on renal scarring in rat model of pyelonephritis. Urology 61(5):1037–1041PubMedCrossRefGoogle Scholar
  25. 25.
    Yilmaz A, Bahat E, Yilmaz GG et al (2007) Adjuvant effect of vitamin A on recurrent lower urinary tract infections. Pediatr Int 49(3):310–313PubMedCrossRefGoogle Scholar
  26. 26.
    Yagmurlu A, Boleken ME, Ertoy D et al (2003) Preventive effect of pentoxifylline on renal scarring rat model of pyelonephritis. Urology 61(5):1037–1041PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Parviz Ayazi
    • 1
    Email author
  • Seyed Alireza Moshiri
    • 2
  • Abolfazl Mahyar
    • 3
  • Mona Moradi
    • 4
  1. 1.Department of Pediatric Infectious Diseases, Clinical Research Center, Qazvin Children HospitalQazvin University of Medical SciencesQazvinIran
  2. 2.Department of Pediatric NephrologyQazvin University of Medical SciencesQazvinIran
  3. 3.Department of PediatricQazvin University of Medical SciencesQazvinIran
  4. 4.Emergency Department of PediatricQazvin University of Medical SciencesQazvinIran

Personalised recommendations