Abstract
When children present with a urinary tract infection (UTI), the goal is early recognition and treatment in an attempt to prevent renal parenchymal damage and subsequent renal scarring. The risks of these events are greatest during infancy. However, a delay in diagnosis and treatment of acute pyelonephritis (APN) can result in scarring at any age. In cases of recurrent pyelonephritis, progressive damage to the kidney can occur (Jakobsson et al., Arch Dis Child 70:111, 1994; Jakobsson et al., Pediatr Nephrol 6:; 328, 1992 ). Renal cortical scarring can result in long-term sequelae including uremia, hypertension, in girls, toxemia of pregnancy and in severe cases, end-stage renal disease. Since renal scarring is the fourth leading cause of renal transplantation in children, the need for early diagnosis, treatment, and evaluation of children with UTIs is significant.
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