Does prompt treatment of urinary tract infection in preschool children prevent renal scarring: mixed retrospective and prospective audits

Archives of Disease in Childhood
Malcolm G CoulthardJohn N S Matthews

Abstract

To test whether active management of urinary tract infections (UTI) in young children by general practitioners can reduce kidney scarring rates. A comparison of two audits in Newcastle, of children aged <8 years, presenting with UTIs ; a retrospective audit of conventional management during 1992-1995 (1990s) versus a prospective audit of direct access management during 2004-2011 (2000s). Kidney scarring rates, and their relationship with time-to-treat. Children with a first UTI in the 2000s compared to those in the 1990s, were referred younger, were half as likely to have a renal scar (girls OR 0.47, 95% CI 0.29 to 0.76; boys 0.35, 0.16 to 0.81), and were about 12 times more likely to have vesicoureteric reflux without scarring (girls 11.9, 4.3 to 33.5; boys 14.4, 4.3 to 47.6). In the 2000s, general practitioners treated about half the children at first consultation. Children who were treated within 3 days of their symptoms starting were one-third as likely to scar as those whose symptoms lasted longer (0.33, 0.12 to 0.72). Most kidney defects seen in children after UTIs, are acquired scars, and in Newcastle, active management in primary care has halved this rate.

References

Oct 1, 1987·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·M P GlauserJ Bille
Sep 10, 1994·BMJ : British Medical Journal·L Pead, R Maskell
Sep 25, 1993·BMJ : British Medical Journal·L JadresicD Stevens
Jul 20, 1996·Lancet·J C ReesM G Coulthard
Nov 15, 1997·BMJ : British Medical Journal·M G CoulthardM J Keir
Aug 13, 2002·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Malcolm G Coulthard
Jun 28, 2008·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Malcolm G Coulthard
Jul 8, 2008·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Mika Venhola, Matti Uhari
Jul 10, 2009·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Malcolm G CoulthardMicheal J Keir
Aug 21, 2010·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Tej K Mattoo
Dec 29, 2011·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Kjell Tullus
Jun 19, 2013·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Michael J KeirMalcolm G Coulthard

❮ Previous
Next ❯

Citations

Jan 18, 2014·Archives of Disease in Childhood·Malcolm G CoulthardMichael J Keir
Dec 30, 2014·The Journal of Emergency Medicine·Kenneth Frumkin
Jun 27, 2014·European Journal of Pediatrics·Kanita LertdumronglukPornpimol Rianthavorn
Apr 1, 2015·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Christopher C ButlerUNKNOWN DUTY study team
Feb 6, 2015·Journal of Clinical Microbiology·Joseph B CanteyChristopher D Doern
Nov 6, 2018·Archives of Disease in Childhood·Kyriaki KaravanakiConstantinos J Stefanidis
Feb 9, 2020·Emergency Medicine Journal : EMJ·Mathew ChandyKaren Pilkington
May 26, 2018·Jornal brasileiro de nefrologia : ʹorgão oficial de Sociedades Brasileira e Latino-Americana de Nefrologia·Denise Swei LoAlfredo Elias Gilio
Mar 22, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Malcolm G Coulthard
Feb 6, 2017·Der Urologe. Ausg. A·E LelligM Riccabona
Jun 30, 2019·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Malcolm G Coulthard
Nov 11, 2020·Scientific Reports·Takuma OhnishiIsamu Kamimaki
Feb 19, 2021·Irish Journal of Medical Science·Mansoor AhmedTimothy Reynolds
Oct 3, 2017·The Journal of Pediatrics·William PrimackMyra Carpenter
Apr 20, 2021·Frontiers in Pediatrics·Göran LäckgrenAndrew J Kirsch
May 30, 2021·European Journal of Pediatrics·Lotem GoldbergMiriam Davidovits

❮ Previous
Next ❯

Software Mentioned

brglm
R
polr

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.