Development and progression of clubbing and scarring in children with recurrent urinary tract infections.

Recent publications state that development and progression of clubbing and scarring do not occur in children with recurrent urinary tract infections. To test this assertion, we reviewed the excretory urograms of 106 children (208 renal units) with carefully documented recurrent bacterial urinary infections which commenced before the age of 10 years. We followed 93 of these renal units radio-logically for at least two years. In 31 kidneys, scarring and clubbing progressed; 4 previously normal kidneys developed scarring and clubbing. Two factors, infection and reflux, appeared important in the development of these changes. This study demonstrates that clubbing and scarring can develop and that existing lesions can progress in children with recurrent bacterial urinary infections.

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