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Can postpyelonephritic renal scarring be prevented?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Pediatrisk inflammationsforskning/Nevéus)
2013 (English)In: Pediatric nephrology (Berlin, West), ISSN 0931-041X, E-ISSN 1432-198X, Vol. 28, no 2, 187-190 p.Article in journal, Editorial material (Refereed) Published
Abstract [en]

Pyelonephritis in childhood may, in the worst cases, lead to long-term cardiovascular morbidity due to tubulointerstitial renal scarring. Renal damage is the end result of an interplay between (1) urinary tract anatomy and function, (2) bacterial virulence factors, and (3) the host innate immune system, which on the one hand manages bacterial clearance, but on the other causes tubulointerstitial inflammation, which underlies the renal scarring. It is unclear how common postpyelonephritic scarring is, and how many of the "scars" in fact represent congenital renal hypoplasia. We do, however, know that some situations have an increased risk for scars, i.e., large renal-uptake defects on initial renal scintigraphy or pyelonephritis in young girls with dilating vesicoureteral reflux. It seems logical that antiinflammatory or antioxidant therapy given concomitantly with antibiotics should lower the risk of postpyelonephritic scarring. Animal studies give some support to this idea, but research on humans has been surprisingly scant. In this issue of Pediatric Nephrology, we publish a study that indicates that antioxidant therapy with vitamin A or E given to children with pyelonephritis may indeed lower the risk for renal scarring. This is a track that needs to be pursued further.

Place, publisher, year, edition, pages
2013. Vol. 28, no 2, 187-190 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-188170DOI: 10.1007/s00467-012-2334-2ISI: 000313431600001PubMedID: 23086593OAI: oai:DiVA.org:uu-188170DiVA: diva2:576585
Available from: 2012-12-13 Created: 2012-12-13 Last updated: 2014-03-05Bibliographically approved

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Nevéus, Tryggve
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