Corticosteroids to prevent kidney scarring in children with a febrile urinary tract infection: a randomized trial.
Corticosteroids to prevent kidney scarring in children with a febrile urinary tract infection: a randomized trial.
复制标题
DOI：
10.1007/s00467-020-04622-3
复制
发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Martin JM
中科院分区：
文献类型：
--
作者：
Shaikh N;Shope TR;Hoberman A;Muniz GB;Bhatnagar S;Nowalk A;Hickey RW;Michaels MG;Kearney D;Rockette HE;Charron M;Lim R;Majd M;Shalaby-Rana E;Kurs-Lasky M;Cohen DM;Wald ER;Lockhart G;Pohl HG;Martin JM
评价辅助性全身性皮质类固醇减少肾瘢痕形成的疗效。以前的研究表明，使用辅助性全身皮质类固醇减少了经放射学证实患有广泛性肾盂肾炎的儿童的肾脏瘢痕形成。皮质类固醇对儿童发热性尿路感染（UTI）的疗效尚未研究。首次发热性UTI的2个月至6岁儿童随机接受皮质类固醇或安慰剂治疗3天（两组均接受抗菌治疗）;在首次UTI后5-24个月使用99 mTc-二巯基琥珀酸肾脏扫描评估肾脏瘢痕形成。我们随机分配了546名儿童，其中385名患有UTI，254名进行了肾脏扫描（而不是计划的320名）。皮质类固醇组和安慰剂组的肾脏瘢痕形成率分别为9.8%（12/123）和16.8%（22/131）（p=0.16），相当于绝对风险降低5.9%（95%置信区间：-2.2，14.1）。虽然随机接受辅助皮质类固醇的儿童往往比随机接受安慰剂的儿童发生更少的肾瘢痕，但未达到统计学显著差异。然而，该研究因未达到预期样本量而受到限制。Clinicaltrials.gov，NCT 01391793，注册日期：2011年7月12日
To evaluate the efficacy of adjuvant systemic corticosteroids in reducing kidney scarring. A previous study suggested that use of adjuvant systemic corticosteroids reduces kidney scarring in children radiologically confirmed to have extensive pyelonephritis. Efficacy of corticosteroids for children with febrile urinary tract infection (UTI) has not been studied. Children aged 2 months to 6 years with their first febrile UTI were randomized to corticosteroids or placebo for 3 days (both arms received antimicrobial therapy); kidney scarring was assessed using 99mTc-dimercaptosuccinic acid kidney scan 5–24 months after the initial UTI. We randomized 546 children of which 385 had a UTI and 254 had outcome kidney scans (instead of the 320 planned). Rates of kidney scarring were 9.8% (12/123) and 16.8% (22/131) in the corticosteroid and placebo groups, respectively (p=0.16), corresponding to an absolute risk reduction of 5.9% (95% confidence interval: −2.2, 14.1). While children randomized to adjuvant corticosteroids tended to develop fewer kidney scars than children who were randomized to receive placebo, a statistically significant difference was not achieved. However, the study was limited by not reaching its intended sample size. Clinicaltrials.gov, NCT01391793, Registered 7/12/2011
登录
查看更多内容
影响因子：
26.1
作者：
Shaikh, Nader;Haralam, Mary Ann;Hoberman, Alejandro
通讯作者：
Hoberman, Alejandro
影响因子：
1.8
作者：
Chen, Jingjing;Liu, Fang
通讯作者：
Liu, Fang
影响因子：
3
作者：
HARAOKA, M;MATSUMOTO, T;KUMAZAWA, J
通讯作者：
KUMAZAWA, J
影响因子：
6.6
作者：
ROBERTS, JA;ROTH, JK;BASKIN, G
通讯作者：
BASKIN, G
影响因子：
3.1
作者：
MEYLAN, PR;MARKERT, M;GLAUSER, MP
通讯作者：
GLAUSER, MP