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Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado

2011, Number 3

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Rev Esp Med Quir 2011; 16 (3)

Urinary tract infection in children with chronic renal failure stages 3, 4 and 5. Prevalence and diagnosis

Olalde CR, López HJ, Vázquez GMJ, Huerta RF

Language: Spanish
References: 17
Page: 139-145
PDF size: 323.08 Kb.


ABSTRACT

Background: In childhood, the urinary tract infection (UTI) is one of the most common infectious diseases. According to the characteristics of child with chronic renal failure, it is possible that the presentation and diagnosis of UTI have their own peculiarities, which are not routinely identified.
Objective: To identify the prevalence, risk factors and most common germs involved in UTI in children with chronic renal failure (CRF) stages 3, 4 and 5.
Patients and methods: Children with CRF stages 3, 4, 5 were included. We registered gender, age, evolution time, cause and stage of renal failure, 24-hour urine volume and IgA. There were performed three urinalysis and three cultures.
Results: Seventy-one patients, 48% female and 52% male, were studied, 33 of them met the inclusion criteria. The average age was 12.8 years. The most common cause was unknown (8 children) and the stage was 3 (55%). Average evolution of CRF was 4.8 years, and prevalence was 3%. When considering changes in the urinalysis arising from the CRF (pH, osmolarity, leukocytes, nitrite and sediment), the prevalence of UTI increased to 57%. Uropathogens isolated were E. coli (three patients), Enterococcus sp (two cases), K. pneumoniae, P. vulgaris and C. tropicalis.
Conclusions: To assume that all patients with chronic renal failure are susceptible to colonization of the urinary tract and that they do not meet diagnostic criteria of UTI, can promote early treatment of the UTI and reduce kidney damage. Prevalence of UTI was of 3% in children with CRF, according to internationally established standards. This is of great importance because it reflects that there is underdiagnosis of UTI, maybe due to the chronic renal failure is superimposed to the UTI.


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