Abstract
Abstract Introduction: Congenital malformations of the urinary system are risk factors for the development of urinary tract infections (UTI). Besides the severity of the malformation, urinary infection is always associated with poor prognosis for these patients. Late discovery of the malformation background, after several urinary tract infection episodes, contributes to the development of chronic pyelonephritis that may lead to chronic renal failure. Material and method: The study involved patients with renal and urinary tract congenital malformations treated at the Pediatric Nephrology Department from Tîrgu Mureș over a period of 6 years, who associated urinary tract infection. Results: Out of the total of 432 patients with congenital malformations of the urinary system, 270 had had at least one or several episode(s) of urinary tract infections in their medical history. Vesico-ureteral reflux and obstructive lesions of the urinary tract were most frequently associated with urinary infections. During the time when no ultrasound screening had been performed, the malformation background was usually diagnosed at the time of the first urinary infection episodes. Conclusions: The incidence of urinary tract infections in patients with renal and urinary tract congenital malformations depends on the type of the underlying malformation, and the time of diagnosis of the malformation background. Prevention of irreversible complications requires early diagnosis of the urinary system malformations that can be performed through ultrasound screening in the neonatal period.
Highlights
Congenital malformations of the urinary system are risk factors for the development of urinary tract infections (UTI)
After studying the incidence of urinary tract infection according to sex and age of the patients of the study group, we noted an increased incidence in males of the newborn and infant age groups, while the urinary tract infection incidence is obviously increased in females in children over 1 year (Table II)
Comparing the data of the 3 years period (2006–2008) when neonatal ultrasound screening of congenital malformations of the urinary system has been performed with data of 3 years period (2003–2005) when this screening has not been performed, we noted a higher frequency of urinary tract infection and recurrent urinary tract infection episodes in the years between 2003 and 2005 (Figure 3)
Summary
Congenital malformations of the urinary system are risk factors for the development of urinary tract infections (UTI). Late discovery of the malformation background, after several urinary tract infection episodes, contributes to the development of chronic pyelonephritis that may lead to chronic renal failure. During the time when no ultrasound screening had been performed, the malformation background was usually diagnosed at the time of the first urinary infection episodes. Congenital malformations of the urinary system and especially obstructive ones are essential contributing factors in the development of urinary tract infections in children [1,2,3]. Other studies showed that the incidence of renourinary malformations in children with urinary tract infection is 40–50%. The late diagnosis of the malformation background worsens the prognosis of these patients
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