URINARY-TRACT INFECTIONS PER SE DO NOT CAUSE END-STAGE KIDNEY-DISEASE

The objective of this study was to determine the frequency with which urinary tract infection (UTI) in the absence of concomitant underlying abnormalities caused end-stage renal disease (ESRD). The records of 1 02 patients with ESRD (disease necessitating dialysis and/or transplan t) seen at Children's Mercy Hospital during a 10-year period (1986-199 5) were reviewed. Obstructive uropathy, aplastic/hypoplastic/dysplasti c kidneys, polycystic kidney disease, congenital nephrotic syndrome, a cquired glomerulonephritis, idiopathic interstitial nephritis, hemolyt ic uremic syndrome, and a variety of systemic conditions were the caus e of ESRD in 99 children; 3 children had reflux nephropathy, 1 of whom had no history of a UTI and another who had a single, afebrile UTI. A girl with a history of recurrent UTIs since 4 years of age had an ele vated serum creatinine and grade II-III bilateral vesicoureteric reflu x when evaluated at 8 years of age. She had ureteral reimplantations a nd control of the infections, but progressed to ESRD. This child appea rs to be the only 1 of 102 children who developed ESRD because of acqu ired renal injury in which UTIs were an important contributing factor.