The evolution of our concepts regarding the pathogenesis of renal inju
ry in children with urinary tract infections is reviewed. Recommendati
ons are made for evaluation and management of children with urinary tr
act infection based on (1) our current perceptions of the pathogenesis
of kidney damage associated with urinary tract infection; (2) the app
ropriate use of the imaging modalities now available for evaluation of
the urinary tract; and (3) the appropriate use of antibiotics.