Effect of Vitamin E on Renal Scarring in Children With Acute Pyelonephritis: A Randomized Controlled Clinical Trial

Abstract

Background: Urinary tract infection (UTI) is among the most common infections in children and acute pyelonephritis (APN) is the most important type of UTI. Late diagnosis and treatment of APN can result in severe complications. This study aimed to evaluate the effect of vitamin E on renal scars in children aged three months to 14 years. Methods: This single-blinded randomized clinical trial (RCT) included all children aged three months to 14 years admitted to tBandar Abbas Children’s Hospital, Bandar Abbas, Iran due to APN in 2017-2018. Patients with renal scars were alternately randomized into two groups. The control group included 41 patients who received 50-75 mg/kg/d intravenous ceftriaxone during hospital stay and the intervention group included 37 cases who received 20 U/kg/d vitamin E tablets in addition to the previous treatment for a total duration of 4 months. Dimercaptosuccinic acid (DMSA) scan was performed at baseline and at the end of 4 months. Results: Out of a total of 78 patients, 34 (43.6%) were boys. Participants of both groups were comparable regarding age and gender. The median of decrease in photopenic areas was insignificantly higher in girls in the vitamin E group compared to girls in the control group (1.26 vs. 1.17, P=0.459). Regardless of gender, decrease in photopenic areas was insignificantly higher in patients aged 1-3 years in the vitamin E group compared to those in the control group (1.40 vs. 1.22, P=0.451). Conclusion: Treatment with vitamin E for at least 4 months may reduce renal scarring in children aged 1-3 years and girls with APN.