THE VALUE OF LEVEL DIAGNOSIS OF CHILDHOOD URINARY TRACT INFECTION IN PREDICTING RENAL INJURY

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Abstract
There were 252 infants and children followed for 2 yr after their 1st urinary tract infection. Each symptomatic infection was determined by simple laboratory examinations as upper pyelonephritic or lower urinary tract infection. I.v. urography was done at the beginning of the follow-up and 2 yr later; micturating cystourethrography was taken after the 3rd infection at the latest. Urological abnormalities were found in 26 patients (10%); 12 subjects (5%) developed renal scars during the study. Patients who had their 1st upper urinary tract infection before the age of 12 mo. numbered 93; 19 of them had urological abnormalities and 10 scars. Two renal scars occurred among the 71 subjects with their 1st pyelonephritic infection after the age of 12 mo. No renal injury was detected in the 88 infants and children with lower symptomatic urinary tract infection or asymptomatic bacteriuria. The determination of the level of the infection may be a useful aid in detecting the harmful scar-forming urinary tract infections. Infants with a pyelonephritic infection are at high risk, and in need of an early urological evaluation.