Abstract

DIAZ ALVAREZ, Manuel et al. Risk of cicatricial renal damage after urinary tract infection in newborns. Rev Cubana Pediatr [online]. 2007, vol.79, n.1, pp. 0-0. ISSN 1561-3119.

The present paper was aimed at  determining the prevalence of cicatricial renal damage and to identify the risk factors contributing to it in newborns with urinary tract infection for the first time. An analytical case-control study of the risk factors was conducted by binominal logistic regression in newborns  with an upper  urinary tract infection acquired in the community that were consecutively admitted in “ Juan Manuel Márquez” University Children Hospital from February 1992 to December 2004. A renal scintigraphy with DMSA was performed to identify renal scars. Chi square test and logistic tests were applied to identify the independent risk factors. The prevalence of renal cicatricial damage was  25.4 %.  In the regression model,  the following risk factors were included for a multivariate analysis: prenatal US with pyelectasia, microorganism different from Escherichia coli, postnatal renal US showing abnormalities, presence of vesiculoureteral reflux of any degree, reinfection during the three first months of life, male sex, delay in the antibiotic treatment ≥ 4 days, leukocyturia ≥ 10 000/mL, unfavorable response to the initial treatment, and bacterimia  to the same organism of urinary infection. Finally, only the prenatal US with pyelectasia and the presence of vesicoureteral reflux of any degree were  significant (p ‹ 0,05). A fourth part of the neonates that had suffered from clinical infection of the upper urinary tract clinically remained with cicatricial renal damage.It was also possible to demonstrate  in a convincing way that starting from the common factor that  all the patients had a clinically upper urinary  tract infection, the pesence of reflux is the independent risk factor associated with the occurrence of cicatricial renal damage.

Keywords : Urinary tract infection; renal scar; newborns; prevalence, risk factor.

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