Após uma primeira infecção do trato urinário, 15% dos pacientes desenvolvem cicatrizes renais detectáveis na cintilografia renal.[30]Shaikh N, Ewing AL, Bhatnagar S, et al. Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics. 2010 Dec;126(6):1084-91.
http://www.ncbi.nlm.nih.gov/pubmed/21059720?tool=bestpractice.com
O refluxo vesicoureteral aumenta o risco de cicatrização renal, principalmente em graus mais altos.[78]Mattoo TK, Chesney RW, Greenfield SP, et al; RIVUR Trial Investigators. Renal scarring in the randomized intervention for children with vesicoureteral reflux (RIVUR) trial. Clin J Am Soc Nephrol. 2016 Jan 7;11(1):54-61.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4702233
http://www.ncbi.nlm.nih.gov/pubmed/26555605?tool=bestpractice.com
[88]Najafi F, Sarokhani D, Hasanpour Dehkordi A. The prevalence of kidney scarring due to urinary tract infection in Iranian children: a systematic review and meta-analysis. J Pediatr Urol. 2019 Aug;15(4):300-8.
http://www.ncbi.nlm.nih.gov/pubmed/31229416?tool=bestpractice.com
O risco de cicatrização diminui com a administração imediata de antibióticos em crianças febris com ITU.[26]Shaikh N, Mattoo TK, Keren R, et al. Early antibiotic treatment for pediatric febrile urinary tract infection and renal scarring. JAMA Pediatr. 2016 Sep 1;170(9):848-54.
http://www.ncbi.nlm.nih.gov/pubmed/27455161?tool=bestpractice.com
No entanto, a maioria das crianças com ITU não apresenta sequelas de longo prazo.[89]Salo J, Ikäheimo R, Tapiainen T, et al. Childhood urinary tract infections as a cause of chronic kidney disease. Pediatrics. 2011 Nov;128(5):840-7.
http://www.ncbi.nlm.nih.gov/pubmed/21987701?tool=bestpractice.com
Infecções recorrentes do trato urinário superior podem causar cicatrização renal e comprometimento renal.[90]Kosmeri C, Kalaitzidis R, Siomou E. An update on renal scarring after urinary tract infection in children: what are the risk factors? J Pediatr Urol. 2019 Dec;15(6):598-603.
https://www.doi.org/10.1016/j.jpurol.2019.09.010
http://www.ncbi.nlm.nih.gov/pubmed/31591046?tool=bestpractice.com
Crianças imunocomprometidas com anormalidades renais estruturais ou funcionais apresentam aumento do risco de infecção recorrente.[78]Mattoo TK, Chesney RW, Greenfield SP, et al; RIVUR Trial Investigators. Renal scarring in the randomized intervention for children with vesicoureteral reflux (RIVUR) trial. Clin J Am Soc Nephrol. 2016 Jan 7;11(1):54-61.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4702233
http://www.ncbi.nlm.nih.gov/pubmed/26555605?tool=bestpractice.com