Anti-relapse therapy in children with chronic secondary pyelonephritis: evaluation of effectiveness and rationale for a differentiated approach

Abstract

Currently, there is no unified system of anti-relapse treatment of pyelonephritis in children.Purpose. To assess the feasibility of prescribing and effectiveness of various anti-relapse therapy regimens to prevent exacerbations of the disease in children with chronic secondary pyelonephritis.Materials and Methods. The study involved 158 children with chronic secondary pyelonephritis aged 2 to 14 years, including 130 (82.3%) girls and 28 boys (17.7%). The children were divided into the following groups: Group A (n=32) — furazidine — 14 days, anti-relapse therapy after 12 months; Group B (n=34) — furazidine — 14 days, then — Canephron 1 month, anti–relapse therapy after 12 months; Group C (n=34) — Canephron 3 months, anti-relapse therapy after 12 months; Group D (n=30) — furazidine — 14 days, then — Canephron 1 month of anti–relapse therapy after 6 months; Group E (n=28) — furazidine — 14 days of anti-relapse therapy was not performed. Results. It was found that the recurrence rate of chronic secondary pyelonephritis for a 24-month follow-up in Group A was 28.1% (n=9), in Group B, 14.7% (n=5), in Group C, 20.5% (n=7), in Group D, 10% (n=3), in Group E, 42.9% (n=12). The timing of relapse of chronic secondary pyelonephritis was different, with the largest increase in the proportion of patients with exacerbations in the period from 6 to 12 months. The average recurrence rate per year in the catamnesis in all children (n=158) was 1.4 [1.2–1.6], during the prospective follow-up, a statistically significant (p=0.001) decrease in the recurrence rate to 0.36 [0.2–0.79] was noted. Conclusion. The data obtained confirm the feasibility of anti-relapse therapy in children with chronic secondary pyelonephritis.