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UTIs in childhood not a cause of adult renal disease

Clinical Question:
Do recurrent childhood urinary tract infections cause chronic kidney disease?

Bottom Line:
Less than 1% of adults with chronic kidney disease have a history of recurrent childhood urinary tract infections (UTIs). It seems, therefore, unlikely that recurrent UTI in children leads to chronic kidney disease. (LOE = 2b)

Reference:
Salo J, Ikäheimo R, Tapiainen T, Uhari M. Childhood urinary tract infections as a cause of chronic kidney disease. Pediatrics 2011;128(5):840-847.  [PMID:21987701]

Study Design:
Meta-analysis (other)

Funding:
Self-funded or unfunded

Setting:
Various (meta-analysis)

Synopsis:
To determine the proportion of recurrent childhood UTIs that result in chronic kidney disease in adulthood, these researchers performing this meta-analysis searched MEDLINE to find articles evaluating this relationship. The also evaluated patient records of 366 patients at a single hospital who, over the course of 2 years, were treated or monitored for chronic kidney disease to determine whether they had an infectious etiology that could be traced to UTI in childhood. They also analyzed the records in a Finnish database of patients who died while undergoing renal replacement therapy before the study started (back to 1960). This "beating of the bushes" to flush out patients with chronic kidney disease was a useful way to identify patients who might have a history of UTI. They identified 1576 patients from published reports, 366 patients from their hospital, and no patients from the registry. Working backward through these patients' records they identified only 1 case of recurrent childhood UTIs that may have caused adult chronic kidney disease (0.3%). No children with reflux and UTI developed chronic kidney disease.

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