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J Pediatr Urol. 2019 May 22. pii: S1477-5131(19)30134-2. doi: 10.1016/j.jpurol.2019.05.011. [Epub ahead of print]

The prevalence of kidney scarring due to urinary tract infection in Iranian children: a systematic review and meta-analysis.

Author information

1
Research Center For Environmental Determinants of Health (RCEDH), School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. Electronic address: farid_n32@yahoo.com.
2
Research Center For Environmental Determinants of Health (RCEDH), School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran. Electronic address: diana_sarokhani@yahoo.com.
3
Social Determinants of Health Research Center, Shahrekord University of Medical sciences, Shahrekord, Iran. Electronic address: alihassanpourdehkordi@gmail.com.

Abstract

INTRODUCTION:

Urinary tract infection is one of the most common diseases in childhood, and can lead to severe complications such as renal scarring in case of lack of diagnosis and timely treatment.

OBJECTIVE:

The aim of this study was to investigate the prevalence of kidney scarring caused by urinary tract infection in Iranian children by meta-analysis.

STUDY DESIGN:

English -language databases including Science Direct, PubMed, Scopus, Web of Science, and Springer, and Persian -language sites including SID, Magiran, Iranmedex, and Medlib, and the Google Scholar search engine were searched by in March 2018 using MeSH keywords. The heterogeneity of studies was studied using the I2 index. Data were analyzed using STATA software, version 15.1.

RESULTS:

In 18 studies, the prevalence of kidney scarring from urinary tract infections in Iranian children was 31% (95% confidence intervalCI: 22%-39%), (which was 14% in girls and 23% in boys. Also, the prevalence of kidney scar in children with urinary reflux was 47% and in children without urinary reflux was 12%. The most common symptom of the renal scar was fever in 61%, followed by urinary reflux in 45% (unilateral in 42% and bilateral in 30%). Also, the prevalence of mild, moderate, and severe reflux, respectively, was 31%, 27%, and 13%. Meta-regression also showed that the prevalence of kidney scar due to urinary tract infections had no significant relationship with the number of samples and years of research (P > 0.05).

DISCUSSION AND CONCLUSION:

About one-third of Iranian children suffering from urinary tract infections had kidney scarring, so that the prevalence is lower in girls than in boys. Also, the prevalence of renal scarring in children with urinary reflux is about four times higher than that in children without urinary reflux.

KEYWORDS:

Children; Iran; Kidney scar; Meta-Analysis; Urinary tract infection

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