Efficacy of corticosteroids in reducing the renal scarring in acute pyelonephritis in children

Background

Renal scarring is a serious and chronic consequence of acute pyelonephritis in children, which may cause late complications in young adults, such as hypertension, chronic renal failure, and preeclampsia. Urinary tract infection is the most common serious infection in childhood, accounts for 5% to 14% of all pediatric emergency centers. This study aimed to evaluate the effect of dexamethasone in reducing or preventing renal scarring in children who were treated with antibiotics for acute urinary tract infection.

Methods

This is a multicenter, randomized, placebo-controlled, double-blind clinical trial, which evaluates the efficacy of dexamethasone in preventing or reducing renal scarring in febrile children (2months to 14 years) with a first-diagnosed urinary tract infection. A total of 120 participants will be enrolled over a 3-year period from 6 sites in Qatar. Participants will be randomized into a therapy arm and a placebo arm; each arm will comprise 60 participants. Participants were allocated to the therapy arm and received dexamethasone, while those who were allocated to the placebo arm received a placebo, orally in the same regime, twice daily for 3 days. Blood and urine investigations will be performed at presentation and after 3 days from beginning antibiotics, renal ultrasonography will be performed over the first month and DMSA scan will be performed 6 months after enrolment. Study medication will be administered in the first 48 hours of starting antibiotics. The DMSA scan for all participants will be read by 3 reference radiologists without knowledge of clinical features or trial arms.

Discussion

The formation of renal scarring will be compared between participants in both arms, the severity of renal scars and all adverse events of the therapy is determined.

Trial registration

This trial has been registered at ClinicalTrials.gov: NCT04654507 (December 4, 2020), https://clinicaltrials.gov/ ct2/show/NCT04654507. Abbreviations: APN = a

Other Information

Published in: Medicine, Case Reports and Study Protocols
License: http://creativecommons.org/licenses/by/4.0/
See article on publisher's website: https://doi.org/10.1097/md9.0000000000000222