BACKGROUND: Numerous factors may contribute to renal tissue injury after urinary tract infection.
We have evaluated the effects of vitamins A or E supplementation in combination with antibiotics for the prevention of renal scarring in acute pyelonephritis.
METHODS: A simple non-blind randomized clinical trial was conducted on 61 children aged 1 month to 10 years between 2004 and 2006. The inclusion criteria were positive urine culture, clinical findings, and 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy-based evidence in favor of acute pyelonephritis. The children were randomized into three treatment groups: 10-day treatment with only antibiotics (control group; n = 25) and 10-day treatment with supplements of vitamin A (n = 17) or vitamin E (n = 18) in addition to antibiotics during the acute phase of infection. The final analysis was performed after excluding male patients. Each patient was evaluated twice by 99mTc-DMSA scintigraphy performed at least 6 months apart. P < 0.05 was considered to be statistically significant.
RESULTS: The analysis included 108 kidney units. The frequency of inflammation at the beginning of therapy was not significantly different in the three groups (63.3 % in vitamin A, 61 % in vitamin E, and 76.2 % in the control group). A worsening of lesions, based on the second 99mTc-DMSA scan, was observed in 42.5, 0, and 23.3 % of the control, vitamin E, and vitamin A patients, respectively (LR = 26.3, P < 0.001).
CONCLUSION: Vitamins A or E supplements were effective in reducing renal scarring secondary to acute pyelonephritis.
Written by:
Sobouti B, Hooman N, Movahed M. Are you the author?
Pediatric Infectious Disease, Ali-Asghar Children Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Reference: Pediatr Nephrol. 2013 Feb;28(2):277-83.
doi: 10.1007/s00467-012-2308-4
PubMed Abstract
PMID: 23052650
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