Do recurrent urinary tract infections cause chronic kidney disease?

A child with normal kidneys is not at significant risk of developing chronic kidney disease (CKD) because of recurrent urinary tract infections (UTIs), according to a study from Finland. To come to this conclusion, investigators used a 3-pronged approach: They performed a systematic literature search on the association between childhood UTIs and CKD, reviewed data for patients with CKD in the area of a tertiary care hospital, and analyzed the causes of CKD among patients who died before the study began while undergoing renal replacement therapy.

The literature search among 1,576 reviewed cases (in 10 studies) revealed no patients for whom childhood UTIs were the main cause of subsequent CKD. Rather, all the children who had experienced childhood UTIs and developed CKD demonstrated structural kidney anomalies in their first kidney imaging studies. Similarly, a review of data for 58 hospital patients who did not have a specific noninfectious cause of CKD found that although 13 of these patients had a history of UTIs in childhood, imaging studies after their first UTIs demonstrated kidney tissue abnormalities, indicating that recurrence of UTI was not a factor in those abnormalities. Finally, kidney disease registry data showed no relationship between CKD and childhood UTIs in patients who died before the study began (Salo J, et al. Pediatrics. 2011;128[5]:840-847).

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