What are the risk factors for renal scarring in pediatric urinary tract infection (UTI)?

Updated: Mar 19, 2019
  • Author: Donna J Fisher, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

A study by Shaikh et al indicates that in children and adolescents with a first UTI, the risk of scarring is doubled in those with either an abnormal renal ultrasonographic finding or with both a fever of 39°C (102°F) or above and a causative organism other than Escherichia coli. The investigators found the predictive ability of a model based on these factors to be only 3-5% below that obtainable with models in which a blood draw and/or a voiding cystourethrogram (VCUG) are needed. The report was a meta-analysis of nine cohort studies, and included 1280 patients aged 18 years or younger. [1, 2] ​The study also indicated that the greatest risk factor for renal scarring is the presence of grade IV or V vesicoureteral reflux (VUR). Of the 199 patients in the study who had renal scarring, 100 had VUR, although only 4.1% of the 1280 patients had grade IV or V type.


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