Document Type

Article

Publication Date

10-2026

Identifier

DOI: 10.1007/s00467-026-07253-2; PMCID: PMC13481756

Abstract

BACKGROUND: Urinary tract and kidney infections are potential complications in pediatric chronic kidney disease (CKD), especially among patients with congenital anomalies of the kidney and urinary tract (CAKUT). We characterized the prevalence of self-reported infections from childhood through young adulthood; evaluated risk factors; and quantified the association with CKD progression.

METHODS: Infections in the past year were self-reported at annual Chronic Kidney Disease in Children (CKiD) study visits. Age-specific infection prevalences were stratified by sex and CKD diagnoses (glomerular, non-glomerular non-CAKUT, CAKUT low-risk for infections, and three CAKUT high-risk categories: reflux nephropathy, obstructive uropathy, and other high-risk). Repeated measures logistic regression quantified associations between infections and clinical variables. Estimated glomerular filtration rate (eGFR) change in the year after infection was assessed using linear regression, adjusted for age, sex, diagnoses, previous year eGFR, medications, and bladder catheterization.

RESULTS: 943 participants contributed 4707 person-visits. Among 175 with obstructive uropathy, approximately one-third of boys and two-thirds of girls reported a previous year infection; infection prevalence for other CAKUT diagnoses ranged from about 20% to 50%. Bladder catheterization and history of infections were significantly associated with recent infections. Adjusted eGFR decline in the year after reporting infection was -1.7% faster compared to those free of infection (95%CI: -3.2%, -0.1%, p <  0.05), but this was attenuated when adjusted for catheterization (p = 0.082).

CONCLUSIONS: CAKUT diagnoses were associated with higher infection risk, especially among those with obstructive uropathy, and girls reported more infections than boys. Self-reported infection was significantly associated with accelerated eGFR decline in the following year.

Journal Title

Pediatric nephrology (Berlin, Germany)

Volume

41

Issue

10

First Page

3377

Last Page

3387

MeSH Keywords

Humans; Male; Female; Urinary Tract Infections; Glomerular Filtration Rate; Child; Prevalence; Risk Factors; Renal Insufficiency, Chronic; Child, Preschool; Adolescent; Disease Progression; Urogenital Abnormalities; Infant; Kidney; Young Adult; Vesico-Ureteral Reflux; Sex Factors

PubMed ID

41882420

Keywords

Bladder infection; Congenital anomalies of the kidney and urinary tract; Glomerular filtration rate; Kidney infection; Pediatric chronic kidney disease; Urinary tract infection

Comments

Grants and funding

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Publisher's Link: https://link.springer.com/article/10.1007/s00467-026-07253-2

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