RESUMO
Background: In children, urinary tract infection (UTI) is a very common disease, and can cause permanent kidney damage. Aim: To determine risk factors for permanent kidney damage, in children with UTI. Patients and methods: In 337 children with UTI (237 female, mean age 4,2 years) a static renal scintigraphy was performed to assess the presence of permanent kidney damage. The history of vesicoureteral reflux and number of episodes of UTI was obtained. Results: One hundred three children had a history of one episode of infection and the rest had recurrent infections. Permanent kidney damage was observed in 161 children (48 percent). This damage was observed in 39 percent of children of less than one year of age, in 43 percent of children aged 1 to 5 years of age and in 58 percent of children older than 5 years (p=0.02). Sixty three percent of 122 children with vesicoureteral reflux had permanent kidney damage, compared with 27 percent of children without this condition (p <0.001). Likewise, damage was observed in 36 percent of children with one episode of infection and 47 percent of children with recurrent infections (p <0.01). No gender differences were observed. Conclusions: Vesicoureteral reflux, recurrence of UTI and age are associated with permanent renal damage in children with UTI
Assuntos
Humanos , Masculino , Pré-Escolar , Feminino , Lactente , Infecções Urinárias , Insuficiência Renal Crônica/epidemiologia , Refluxo Vesicoureteral , Fatores de Risco , Distribuição por Idade , Distribuição por SexoRESUMO
La enfermedad pulmonar interstical crónica es frecuente en lactantes y comprende un grupo heterogéno de enfermedades con patrón histológico semejante. Se presenta el caso de una lactante que inició su sintomatología en el período neonatal, con neumonías y atelectasias repetidas, asociadas a transtornos de la deglución con aspiración hacia la vía aérea. El estudio radiológico de tórax demostró infiltrados intersticiales bilaterales persistentes. La biopsia pulmonar fue compatible con una neumonía crónica interstical histiocitaria. Se trató con oxigenoterapia permanente, corticoides inhalatorios, broncodilatadores, kinesiterapia respiratoria, prednisona oral, que luego se cambió a cloroquina, la cual se mantiene hasta la fecha (tiempo de admini9stración 34 meses). La evolución clínica y radiológica ha sido favorable, lográndose la suspensión de la oxigenoterapia luego de un año de uso. Después del primer año de tratamiento no ha presentado neumonías y no han aparecido efectos secundarios por el uso prolongado de cloroquina. Su desarrollo pondoestatural no ha sido adecuado ya que es portadora de una genopatía aún no precisada, sin relación con la enfermedad pulmonar