Impact of delayed treatment on renal injuries in pediatric urinary tract infections

Urinary tract infection (UTI) is a common health problem among children that may lead to irreversible renal injuries. The aim of the present study was to determine the association between the delay in treatment of urinary tract infection and risk of renal damage

For this retrospective study 100 children aged 1 month to 14 years who were admitted with urinary tract infection in Mofid Children`s Hospital from March 2000 to September 2004 were included. The lag time between the onset of disease and treatment, DMSA scan results prior to treatment and 6 months later, urine analysis, and patient's clinical manifestations were all recorded. UTI was diagnosed based on clinical manifestations, culture, and pylonephritis detected in DMSA scan.

The study population included 77 girls and 23 boys with the mean age of 3 years and 3 months (range 1 month to 14 years). The mean lag time between disease onset and treatment was 4.6 days. Kidney damages were reported to be least among those with mean lag time of 2.6 days and worst among those with the mean lag time of 6.6 days.

Irreversible renal scars were shown in one third of patients who had a mean lag time of 6 days. Efforts to reduce the incidence and severity of renal scarring should be directed towards rapid diagnosis and effective early management of urinary tract infections in infancy and childhood.