On July 1, the official journal of the American Academy of Pediatrics just published an important study on
urinary tract infections.

Many of you may not realize it, but there are actually two reasons we like to diagnose and treat urinary tract infections
  1. To help your child feel better. Curing the illness ends the symptoms
  2. Prevent kidney damage. Some UTI's spread to the kidney and cause scarring.
For many, many years, the teaching has been that UTI's are more likely to spread to the kidney if you are an infant
and if you have reflux.

Reflux is a condition in the urinary system in which urine goes up to the kidney as well as out into the toilet when you
urinate. Reflux is a physical property of your urinary system and is not caused by infection. You either have it
or you do not. With time those with reflux tends to stop having reflux as they get older.

The New Findings
Now comes a very important study of many hundreds of children with first time UTI's, from age 1 month to age 14 years.
Everyone with such a UTI had fever measured, some blood tests, and two radiology studies that proved if the
person had reflux and if the person had actual kidney infection with their UTI. Six months later they repeated a study
to see if any scars developed in the kidney.

This is the first time anyone has actually directly measured whether a child's UTI caused kidney infection and later kidney scarring

What they found was that the our prior understandings were quite wrong.

If you have a UTI, you are much more likely to have kidney infection as you get older, infants are actually less likely to
have kidney infection when they have a UTI.

Further, there appears to be no connection between reflux and getting a kidney infection or later kidney scarring from
an infection.

How This Changes How UTI's Should be Managed
Prior to this study, the question of whether you had reflux to your kidneys seemed critically important to protecting the
kidneys in future UTI's. This no longer appears to be the case.
Prior to this study, it was clear that doing a study to find out if you have reflux, now this intervention seems no longer
important to do.

At this time, the state-of-the-art approach to managing UTI's will be to:
  1. Obtain a urine sample to see if there is an infection
  2. Only if there is a bacterial infection, treat with antibiotics
  3. Make sure you get better.
This appears the best way to make your child feel better and to protect the kidneys.

The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

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