دوره 33، شماره 157 - ( 1-1404 )
جلد 33 شماره 157 صفحات 10-10 |
برگشت به فهرست نسخه ها
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Seyedzadeh A, Tohidi M R, Mohammadi Kamalvand M. The Effect of Vitamin A and Corticosteroid in Reducing Kidney Scars in Children with Acute Pyelonephritis: A Clinical Trial Study. J Adv Med Biomed Res 2025; 33 (157) :10-10
URL: http://journal.zums.ac.ir/article-1-7465-fa.html
URL: http://journal.zums.ac.ir/article-1-7465-fa.html
The Effect of Vitamin A and Corticosteroid in Reducing Kidney Scars in Children with Acute Pyelonephritis: A Clinical Trial Study. Journal of Advances in Medical and Biomedical Research. 1404; 33 (157) :10-10
چکیده: (23 مشاهده)
Background and objective: The effect of vitamin A and Corticosteroids in reducing kidney scars in children with acute Pyelonephritis (PN).
Materials and Methods: Forty-five children with PN were assigned to three groups of vitamin A (n= 15), Corticosteroid (n= 15) and placebo (n= 15). In addition to standard treatment for all patients, the first group received vitamin A once daily with 25,000 units for children under one year and 50,000 units for one year of age and older children during three days of hospitalization intravenously. The second group received Corticosteroids (dexamethasone) daily 0.15 mg/kg/day in two divided intravenous doses (25) during three days of hospitalization. The placebo group received normal saline as an injection. Follow-up continued for six months.
Results: The recovery rate of abnormal lesions in the vitamin A, Corticosteroid and placebo groups was 46.7%, 6.7% and 26.7% respectively (P-Value=0.016). Also, the results of 99mTc-dimercaptosuccinic acid (DMSA) before and after intervention was statistically significant only for the group receiving vitamin A, so that 46.7% of the total 66.7% patients with abnormal lesions in the first 99mTc-DMSA scan had improved after the intervention in the the second 99mTc-DMSA scan (P-Value =0.001).
Conclusion: Vitamin A may be effective in reducing kidney scars in children with APN.
Materials and Methods: Forty-five children with PN were assigned to three groups of vitamin A (n= 15), Corticosteroid (n= 15) and placebo (n= 15). In addition to standard treatment for all patients, the first group received vitamin A once daily with 25,000 units for children under one year and 50,000 units for one year of age and older children during three days of hospitalization intravenously. The second group received Corticosteroids (dexamethasone) daily 0.15 mg/kg/day in two divided intravenous doses (25) during three days of hospitalization. The placebo group received normal saline as an injection. Follow-up continued for six months.
Results: The recovery rate of abnormal lesions in the vitamin A, Corticosteroid and placebo groups was 46.7%, 6.7% and 26.7% respectively (P-Value=0.016). Also, the results of 99mTc-dimercaptosuccinic acid (DMSA) before and after intervention was statistically significant only for the group receiving vitamin A, so that 46.7% of the total 66.7% patients with abnormal lesions in the first 99mTc-DMSA scan had improved after the intervention in the the second 99mTc-DMSA scan (P-Value =0.001).
Conclusion: Vitamin A may be effective in reducing kidney scars in children with APN.
نوع مطالعه: کارآزمایی بالینی |
موضوع مقاله:
Clinical Medicine
دریافت: 1403/11/9 | پذیرش: 1404/2/11 | انتشار: 1404/3/8
دریافت: 1403/11/9 | پذیرش: 1404/2/11 | انتشار: 1404/3/8
فهرست منابع
1. Tullus K, Shaikh N. Urinary tract infections in children. Lancet. 2020;395(10237):1659-68. [DOI:10.1016/S0140-6736(20)30676-0] [PMID]
2. Khanali F, Mehramiz M, Dalirani R, Parsarad E, Arad B. Doppler ultrasonography in children with acute pyelonephritis in diagnosis of renal scar compared to DMSA scintigraphy. Tehran Univ Med J TUMS Publications. 2021;78(10):651-7.
3. Parente G, Gargano T, Pavia S, Cordola C, Vastano M, Baccelli F, et al. Pyelonephritis in pediatric uropathic patients: differences from community-acquired ones and therapeutic protocol considerations-a 10‑year single‑center retrospective study. Children (Basel). 2021;8(6):436. [DOI:10.3390/children8060436] [PMID] [PMCID]
4. Williams E, Papineni P, Bhagani S, Harber M. Infections and the kidney. In: Primer on Nephrology. Springer; 2022. pp. 543-64. [DOI:10.1007/978-3-030-76419-7_30] [PMCID]
5. Pleniceanu O, Twig G, Tzur D, Sherman G, Afek A, Erlich T, et al. Acute pyelonephritis in children and the risk of end‑stage kidney disease. J Nephrol. 2021;34:1757-65. [DOI:10.1007/s40620-020-00841-x] [PMID]
6. Ayazi P, Moshiri SA, Mahyar A, Moradi M. The effect of vitamin A on renal damage following acute pyelonephritis in children. Eur J Pediatr. 2011;170:347-50. [DOI:10.1007/s00431-010-1297-1] [PMID]
7. Shaikh N, Ewing AL, Bhatnagar S, Hoberman A. Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics. 2010;126(6):1084-91. [DOI:10.1542/peds.2010-0685] [PMID]
8. Kahbazi M, Sharafkhah M, Yousefichaijan P, Taherahmadi H, Rafiei M, Kaviani P, et al. Vitamin A supplementation is effective for improving the clinical symptoms of urinary tract infections and reducing renal scarring in girls with acute pyelonephritis: a randomized, double‑blind, placebo‑controlled clinical trial. Complement Ther Med. 2019;42:429-37. [DOI:10.1016/j.ctim.2018.12.007] [PMID]
9. Lee HB, Lee S, Choi YH, Cheon JE, Lee SB, Cho YJ, et al. Contrast‑enhanced ultrasound for the diagnosis of acute pyelonephritis in pediatric patients with urinary tract infection: a feasibility study. PLoS One. 2023;18(4):e0284016. [DOI:10.1371/journal.pone.0284016] [PMID] [PMCID]
10. Laperrousaz S, Drepper VJ. Overview of peritoneal dialysis. Rev Med Suisse. 2016;12(507):408-12. [DOI:10.53738/REVMED.2016.12.507.0408] [PMID]
11. Jääskeläinen J, Renko M, Kuitunen I. Corticosteroids to prevent renal scarring in children with pyelonephritis: a systematic review and meta‑analysis. J Nephrol. 2023;36:1-10. [DOI:10.1007/s40620-022-01552-1] [PMID] [PMCID]
12. Zhang GQ, Chen JL, Zhao Y. The effect of vitamin A on renal damage following acute pyelonephritis in children: a meta‑analysis of randomized controlled trials. Pediatr Nephrol. 2016;31:373-9. [DOI:10.1007/s00467-015-3098-2] [PMID]
13. Şener G, Tuğtepe H, Velioğlu‑Öğünç A, Çetinel Ş, Gedik N, Yeğen BÇ. Melatonin prevents neutrophil‑mediated oxidative injury in Escherichia coli‑induced pyelonephritis in rats. J Pineal Res. 2006;41(3):220-7. [DOI:10.1111/j.1600-079X.2006.00357.x] [PMID]
14. Bıyıklı NK, Tuğtepe H, Şener G, Velioğlu‑Öğünç A, Çetinel Ş, Midillioğlu Ş, et al. Oxytocin alleviates oxidative renal injury in pyelonephritic rats via a neutrophil‑dependent mechanism. Peptides. 2006;27(9):2249-57. [DOI:10.1016/j.peptides.2006.03.029] [PMID]
15. Rius‑Gordillo N, Ferré N, González JD, Ibars Z, Parada‑Ricart E, Fraga MG, et al. Dexamethasone to prevent kidney scarring in acute pyelonephritis: a randomized clinical trial. Pediatr Nephrol. 2022;37(9):2109-18. [DOI:10.1007/s00467-021-05398-w] [PMID] [PMCID]
16. Öztürk R, Murt A. Epidemiology of urological infections: a global burden. World J Urol. 2020;38:2669-79. [DOI:10.1007/s00345-019-03071-4] [PMID]
17. Wagenlehner FM, Bjerklund Johansen TE, Cai T, Koves B, Kranz J, Pilatz A, et al. Epidemiology, definition and treatment of complicated urinary tract infections. Nat Rev Urol. 2020;17(10):586-600. [DOI:10.1038/s41585-020-0362-4] [PMID]
18. Yousefichaijan P, Rezagholizamenjany M, Kahbazi M, Rafiei M, Taherahmadi H, Kaviani P, et al. The effect of vitamin A on clinical manifestations of recurrent pyelonephritis in children. Nephro-Urol Mon. 2020;12(3):e103037. [DOI:10.5812/numonthly.103278]
19. Dalirani R, Yousefi ZM, Sharifian M, Mohkam M, Karimi A, Fahimzad A, et al. Role of vitamin A in preventing renal scarring after acute pyelonephritis. Nephro-Urol Mon. 2011;3(1):31-7.
20. Ebadi M, Mohammadi M, Pezeshki A, Jafari SM. Beta‑carotene. In: Handbook of Food Bioactive Ingredients: Properties and Applications. Springer; 2023. pp. 603-28. [DOI:10.1007/978-3-031-28109-9_51]
21. Sürmeli Döven S, Erdoğan S. Vitamin D deficiency as a risk factor for renal scarring in recurrent urinary tract infections. Pediatr Int. 2021;63(3):295-9. [DOI:10.1111/ped.14397] [PMID]
22. Sobouti B, Hooman N, Movahed M. The effect of vitamin E or vitamin A on the prevention of renal scarring in children with acute pyelonephritis. Pediatr Nephrol. 2013;28:277-83. [DOI:10.1007/s00467-012-2308-4] [PMID]
23. Dalirani R, Zoshk MY, Sharifian M, Mohkam M, Karimi A, Fahimzad A, et al. Role of Vitamin A in Preventing Renal Scarring After Acute Pyelonephritis. Iran J Kidney Dis. 2011;5(5):320.
24. Bhaskaram P. Micronutrient malnutrition, infection, and immunity: an overview. Nutr Rev. 2002;60(suppl 5):S40-5. [DOI:10.1301/00296640260130722] [PMID]
25. Huang YY, Chen MJ, Chiu NT, Chou HH, Lin KY, Chiou YY. Adjunctive oral methylprednisolone in pediatric acute pyelonephritis alleviates renal scarring. Pediatrics. 2011;128(3):e496-504. [DOI:10.1542/peds.2010-0297] [PMID]
26. Sakulchit T, Goldman RD. Corticosteroids for renal scar prevention in children with acute pyelonephritis. Can Fam Physician. 2017;63(4):286-7.
27. Meena J, Kumar J. Adjuvant corticosteroids for prevention of kidney scarring in children with acute pyelonephritis: a systematic review and meta‑analysis. Arch Dis Child. 2021;106(11):1081-6. [DOI:10.1136/archdischild-2020-320591] [PMID]
28. Shaikh N, Shope TR, Hoberman A, Muniz GB, Bhatnagar S, Nowalk A, et al. Corticosteroids to prevent kidney scarring in children with a febrile urinary tract infection: a randomized trial. Pediatr Nephrol. 2020;35:2113-20. [DOI:10.1007/s00467-020-04622-3] [PMID] [PMCID]
| بازنشر اطلاعات | |
 |
این مقاله تحت شرایط Creative Commons Attribution-NonCommercial 4.0 International License قابل بازنشر است. |