Sun, 09/12/2010 - 05:36 | by admin
Implications of a UTI
UTIs, especially febrile infections, are often associated with a significant degree of illness (morbidity) as a result of the symptoms. Infants and young children suffering from severe pyelonephritis can become acutely ill, and many require hospitalization.
Implications for families
UTIs constitute a significant cost to both families and the healthcare systems. Costs relate to medication, physician time and a potential hospital stay. There is also the issue of children missing school, as well as parents needing to take time from off work to provide care for their children
Infection of the kidneys can have serious long-term consequences. UTIs involving the kidneys may lead to damage (scarring) of the renal tissue. This is particularly relevant in younger children who are both more likely to suffer UTIs and more vulnerable to potential renal damage as a result of the infection. This type of renal damage can lead to complications later in life including:
- An increased risk of developing hypertension
- Complications during pregnancy (pre-eclampsia)1
- End-stage renal disease2, 3, 4
Recurrent UTIs could be something more
UTIs, especially recurrent infections, can be indicative of an underlying abnormality of the urinary tract, most commonly vesicoureteral reflux (VUR). VUR occurs in approximately 1% of all children.6 However, VUR is usually only diagnosed in association with recurrent UTIs. In children with VUR, urine travels backwards from the bladder, back up through the ureters, and towards the kidneys An estimated 30–40% of children with recurrent UTIs are found to have this condition.3, 5
- McGladdery SL, Aparicio S, Verrier-Jones K, et al. Outcome of pregnancy in an Oxford-Cardiff cohort of women with previous bacteriuria. Q J Med 1992; 83: 533-539.
- Orellana P, Baquedano P, Rangarajan V, et al. Relationship between acute pyelonephritis, renal scarring, and vesicoureteral reflux. Results of a coordinated research project. Pediatr Nephrol 2004; 19: 1122-1126.
- Panaretto K, Craig J, Knight J, et al. Risk factors for recurrent urinary tract infection in preschool children. J Paediatr Child Health 1999; 35: 454-459.
- Zhang Y, Bailey RR. A long-term follow-up of adults with reflux nephropathy. N Z Med J 1995; 108: 142-144.
- Wheeler DM, Vimalachandra D, Hodson EM, et al. Interventions for primary vesicoureteric reflux. Cochrane Database Syst Rev 2004: CD001532.
- Jacobson SH, Hansson S, Jakobsson B. Vesico-ureteric reflux: occurrence and long-term risks. Acta Paediatr Suppl 1999; 88: 22-30.