Background: Enuresis is one of the most common diseases in children. Although there are several factors involved in the occurrence of this diseases, the root cause of it has remained undetermined. Objectives: Identifying various factors responsible for enuresis may enormously contribute to solving this problem. This study, therefore, aimed to determine the level of vitamin B12 and folic acid in children with enuresis in Gorgan in 2021. Methods: In this case-control study, 43 children with primary enuresis and 99 children without enuresis, as the control group, referring to Taleghani Hospital in 2021 were included. Folic acid and vitamin B12 levels in two groups were measured and analyzed using statistical techniques. Results: Out of all participants, 23 (53.5%) in the case group and 53 (53.5%) in the control group were male. The mean age of children in the case and control groups were 7.60 ± 3.02 and 8.93 ± 3.15, respectively, and the two groups were not significantly different in terms of gender and age. Vitamin B12 and folic acid levels in the case group were significantly lower than those in the control group (P-value = 0.001). There was a significant difference between the case and control groups regarding the mean levels of vitamin B12 and folic acid levels based on sex and gender. Conclusions: In sum, it was found that children with enuresis suffered from deficiency of vitamin B12 and folic acid to some extent, which may have been a factor responsible for delaying the maturation of the central nervous system and, consequently, inducing enuresis in children.

Background: Enuresis is bedwetting that occurs during sleep in children over five years old. If left untreated, it can lead to social and psychological problems for children and their parents. The role of copeptin in patients with primary monosymptomatic nocturnal enuresis (PMNE) has been reported in several studies. Due to the favorable structural properties of copeptin and the reflection of arginine vasopressin (AVP) concentration, it can be used as an alternative marker for AVP secretion. Objectives: This study aims to compare the levels of copeptin in healthy and enuresis children aged 5 - 15 years. Methods: This case-control study was performed on 42 children with primary monosymptomatic enuresis and 42 children without enuresis who were referred to the clinic of Taleghani hospital in Gorgan in 2020. Copeptin levels were measured by the enzyme-linked immunosorbent assay (ELISA) method. Results: Out of 84 patients, an equal proportion of girls (21 patients) and boys (21 patients) participated in both the case and control groups. The age of the children was 8.05 ± 2.46 years, and there was no statistically significant difference between the two groups (P = 0.16). The mean level of copeptin in the case and control groups were 6.7 ± 4.27 and 6.87 ± 8.52 pg/mL, respectively, significantly lower in the case group (P = 0.03). There was a statistically significant difference in the level of copeptin between the boys in the two groups (P = 0.03). Although the mean level of copeptin in the girls in the patient group was lower than that in the control group, this difference was not statistically significant (P = 0.35). Conclusions: In this study, the mean level of copeptin in PMNE was significantly lower than that in the control group, which suggests it may be considered as a probable biomarker for the prediction of response to treatment with desmopressin, but further study is required to confirm this hypothesis.

Background. Congenital hydronephrosis is one of the most common abnormalities of the upper urinary tract, which can be exacerbated by a variety of intrinsic or extrinsic triggers. The urinary tract system is one of the major organs complicated by COVID-19 infection. Case Presentations. Here, we report five patients with an established diagnosis of congenital hydronephrosis, who presented with acute abdominal pain and fever and an abrupt increase in the anteroposterior pelvic diameter (APD). Patients had a previous stable course and were under regular follow-up with serial ultrasonographic studies. They underwent surgery or supportive treatment due to the later exacerbation of hydronephrosis. Based on the clinical and imaging findings, no plausible etiologies for these exacerbation episodes, including infection, nephrolithiasis, or abdominal masses, could be postulated. The common aspect in all these patients was the evidence of a COVID-19 infection. Conclusions. Infection with COVID-19 in children with antenatal hydronephrosis may exacerbate the degree of hydronephrosis and renal APD in ultrasonography, which itself may be mediated by the increase in inflammatory mediators.

Background: Lymphadenitis is the most common complication following BCG vaccination observed in 0.1% to 1% of children. Objectives: The presence of immunodeficiency can increase the probability of lymphadenitis or contribute to its exacerbation, so the early detection of immunodeficiency in those developing lymphadenitis can help prevent its many catastrophic complications. Methods: This study was performed on patients referred to Taleghani Hospital of Gorgan city in 1396. Forty children with lymphadenitis and 40 healthy children entered the study. Serum samples were taken to measure white blood cell counts and the antibodies, including IgE, IgG, IgM, and IgA. Purified protein derivative (PPD) test was done in both groups. Results: In this study, there were 40 patients with lymphadenitis, of whom 24 were boys (60%), and 16 were girls (40%), and in the control group were 22 boys (55%) and 18 girls (45%). There was no statistically significant difference between the two groups. Lymphadenitis was ipsilateral to the vaccine injection site in all 40 cases, and it was in the anterior axillary region in 82%. Abscess at the lymphadenitis site occurred in 25% of cases. The mean size of induration following PPD in the lymphadenitis group was larger than the control group (5.86 mm and 3.04 mm, respectively) (P = 0.004). There were five patients (12.5%) under one year of age with lymphopenia (lymphocyte count 3,000 >), but no lymphopenia was observed in the control group. The mean average IgA and IgM levels were different between the case and control groups (P = 0.001), (P = 0.016), respectively. There was no statistical difference in IgG and IgE levels between both groups (P = 0.92 and P = 0.762, respectively). Conclusions: This study shows that the size of indurations following PPD injection is higher in those with post-vaccination lymphadenitis. Although the probability of a primary immunodeficiency disorder in the cases of our study was low considering the normal immunoglobulin levels and CBC report, further studies with a larger sample size and more specific investigations, such as flow cytometry and specific antibody response, are needed.

Background: Hypertension (HTN) is a significant public health problem worldwide. Early diagnosis of HTN and its related risk factors has been considered as one of the main requirements of general healthcare in children. Objectives: This study aimed to examine the nomograms of normal systolic and diastolic blood pressure (BP) and the prevalence of asymptomatic HTN and pre-HTN in a population of school-aged children. Methods: Systolic and diastolic BP, height, and weight were measured in 5811 healthy school-aged children (2904 males and 2907 females) during healthcare visits. HTN was defined as systolic or diastolic BP ≥ 95th percentile for age, gender, and height of the screened population on ≥ 3 occasions. Pre-HTN was considered as systolic or diastolic BP between 90 - 95 percentile. Results: HTN and pre-HTN were detected in 8.4% and 7.8% of the children, respectively. The prevalence of HTN was 8.6% among the males and 8.2% among the females. Systolic HTN and pre-HTN were detected in 5.8 and 6.4% of the cases compared to diastolic HTN and pre-HTN observed in 5.9 and 6.1% of the participants, respectively. In addition, HTN was detected in 27.9% of children with obesity. Conclusions: According to the high incidence of asymptomatic HTN and pre-HTN in asymptomatic children, it is recommended to perform routine BP measurement during medical care visits of all healthy school children and to prevent and treat obesity in childhood.

Background: Computerized Tomographic (CT) scan is a rapid, non-invasive, and common diagnostic modality in radiology. More and faster growth of cells, as well as longer lifespan of a child, may lead to a cumulative effect of radiation and a greater chance of mutation, especially in children who are more vulnerable. Objectives: This study was designed to evaluate the current trend in the use of this modality. Methods: In this descriptive study, all cases of children admitted to Taleghani Hospital who were studied by CT scan during the years 2018 - 2019, entered in survey. Demographic information, anatomical location of the scan, findings from the CT scan report, initial and final diagnosis, number of scans, patient’s complaint that led to his hospitalization and total amount of radiation received by the patient were analyzed. The data were analyzed by SPSS software version 23 with descriptive statistics (frequency, frequency percentage, and mean and standard deviation). Results: In this study, 344 scans of 280 patients were reviewed. Out of 280 patients, 222 patients underwent scan of one, 55 patients of two and four patients of three different anatomical locations. There were 146 male patients (52.1%) with a mean age of 57.7 months and 134 female patients (47.9%) with a mean age of 54.7 months. Out of all scans, the brain constituted 43.6%, chest 30.52%, and other areas 25%. The CT scan was performed at the request of the physician in charge. Pneumonia (19%) followed by convulsion (17%) and febrile seizures (12%) were the most common final diagnoses. The number of completely normal CT scans was 151 (44.2%), with brain scans having the highest frequency of normal scans with 74.19%. Brain scans with an average of 358.66 milliGray.centimeter (mGy.cm) and a maximum of 995.30 mGy.cm had the highest average absorbed dose. Conclusions: In this study, the rate of normal CT scans was relatively high and the range of radiation exposure available for each modality was significantly wide. Effective interventions must be made in this regard.

Background and objectives: Diagnosis and treatment of urinary tract infection (UTI) in children before kidney damage is necessary. The purpose of this study was to compare efficacy of co-trimoxazole and cephalexin in the prevention of recurrent UTI in children. Methods: The study was performed on 100 children aged three months to 14 years who were referred to the Taleghani Pediatric Hospital in Gorgan (Iran) during 2016. The subjects had a history of UTI and required antibiotic prophylaxis to prevent UTI. They were divided into two groups of co-trimoxazole and cephalexin. Data were analyzed using SPSS (version 18) and at significance level of 0.05. Results: Recurrent UTI was observed in eight children (16.0%) taking cephalexin and in six children (12.0%) receiving co-trimoxazole (p=0.56). Urine culture examination revealed Escherichia coli as the causative agent of UTI in six cases (75 %) receiving cephalexin and in five cases (83.3%) receiving co-trimoxazole (p=0.70). It should be noted that unilateral moderate hydronephrosis was the most frequent anomaly (n=26) in the study groups. Conclusion: According to the results of the present study, both cephalexin and co-trimoxazole have similar efficacy in the prevention of UTI among children.

Background: We need some simpler, cheaper, and less burdensome tools to investigate the severity of renal parenchymal involvement in children with clinical pyelonephritis. Objectives: The present study was designed to investigate the relationship between electrolyte changes with renal involvement as documented by dimercaptosuccinic acid (DMSA) scan in children with febrile urinary tract infection (UTI). Methods: This is a retrospective cohort study, involving 158 children aged two months to 14 years with febrile UTI admitted to Taleghani Hospital in Gorgan from 2018 to 2019. Their documents in hospital were analyzed. They were divided into two groups with positive or negative defects on DMSA scan. Clinical and laboratory data were studied. Statistical analysis was performed using SPSS version 18. Data were analyzed using independent t-test with normal distribution of variables, otherwise chi-square test was used. The statistical significance level of the study was considered 0.05. Results: Among the 158 children, 78 patients (49.4%) had normal DMSA scan results, and 80 patients (50.6%) had an abnormal result. The mean age in month was not different between the two groups. In patients with positive renal cortical defects on DMSA scan (group 2), ESR was significantly higher than the first group (P < 0.05). The mean serum Na level in the second group was lower than in the first group; however, it was only slightly significant (P = 0.058). The two groups showed no difference with respect to serum potassium, urine specific gravity (SG), WBC count, and the duration of fever (P > 0.05). The frequency distribution of proteinuria was not different between the two groups (P = 0.836). Conclusions: We suggest that increased ESR, positive CRP, and the presence of reflux can predict renal parenchymal involvement in children with febrile UTI as evidenced by a positive finding on DMSA scan, and the presence of hyponatremia has a little predictive value in this regard.

COVID-19 pandemic due to the new corona virus 2019 is an important cause global problems. This infection begins with symptoms such as fever, cough, anorexia, malaise, sore throat, and can progress to acute respiratory disease syndrome (ARDS) and necessitating intensive care unit (ICU) admission with an estimated mortality rate of 3%.There is no confirmed specific antiviral treatment despite different treatment protocols. Supportive care especially fluid therapy plays a very important role in this disease. The aim of this review is to Institute effective strategies for effective fluid therapy in critically ill pediatric patients admitted to ICU. Keywords: COVID-19; Corona virus disease 2019; SARS-CoV-2; Fluids; Child; Intensive care.

Background: Cystic Fibrosis (CF) is a systemic autosomal disorder and the most important chronic lung disease in children. Oxalate is the end product of vitamin C metabolism, which increases the risk of kidney stones, urinary bladder stones, and calcium deposits in CF patients. Objectives: Considering the increased mineral excretion and the rate of stone formation in the urinary tract, examining the excretion of minerals will greatly help resolve clinical problems. Methods: This descriptive-analytical study was performed on CF and healthy children in Gorgan in 2018 - 19. In this study, 40 CF children and 40 healthy children were randomly selected. After obtaining informed consent from the parents of the children, a random urine sample was collected to evaluate urine minerals. Children with abnormal urinary mineral excretion underwent ultrasonography. The data were analyzed by SPSS 18 using descriptive indices (mean ± SD, frequency, and percentage) and statistical tests (independent t-test, chi-square test, and nonparametric tests). Results: Out of 80 CF and healthy children, 34 were girls, and the rest was boys. The mean age of the patients was 4.34 ± 3.38. The age difference was not significant between the groups (P > 0.05). The mean urinary levels of phosphorus, uric acid, magnesium, and citrate were 0.87 ± 1.01, 1.16 ± 0.68, 0.23 ± 0.18, 2.37 ± 3.13 mg/mg of creatinine. In the pediatric patient group, respectively (P < 0.001). The mean urinary calcium level in CF patients was 0.28 ± 0.39, which was lower than that in the healthy group. The mean urinary oxalate level was 0.13 ± 0.20 in CF patients, which was higher than that in the healthy group (P > 0.05). Hyperoxaluria, hyperuricosuria, hypomagnesiuria, and hypocitraturia occurred in 35, 30, 62, and 7.5% of the CF patients, respectively. Among the urinary minerals studied, hyperoxaluria was found to be a major determinant of stone formation risk in CF. No correlation was observed between the formation of stones and the rate of excretion of minerals (P > 0.05). Conclusions: In summary, CF patients are at an increased risk of developing citrate and calcium stones compared to the healthy group, which is associated with hyperuricosuria, hypocitraturia, and hyperoxaluria.

COVID-19, a disorder caused by a novel coronavirus, is a major global human threat. Patients with end stage renal disease and those undergoing dialysis constitute a susceptible population because of their less efficient immune system. Hemodialysis wards are considered as a high-risk area in the outbreak of a COVID-19 epidemic, therefore prevention plays a key role which is essential in the mitigation and containment of the COVID-19 outbreak in hemodialysis centers. We try to classify prevention guidelines concisely in this article for easier implementation. Keywords: COVID-19; Nephropathy; Dialysis; Prevention.

OBJECTIVE Considering the predictive role of the relatively low urinary citrate for stone formation, especially in hypercalciuric patients, this study is aimed at comparing urine calcium to citrate (Ca/Cit) ratio in 3 groups of children, including patients with idiopathic hypercalciuria with and without renal stone as well as the healthy children. METHODS This study was carried out on 96 children (2 to 12 years old) referred to a pediatric nephrology clinic in the city of Ahvaz, Southwest Iran. All the children underwent renal ultrasonography, urinalysis, and measurement of random nonfasting urine Ca, Cr, and citrate. Those with secondary hypercalciuria, urinary tract malformations, and/or functional abnormalities of the gastrointestinal tract were excluded from the study. RESULTS The mean Ca/Cit. ratio (mg/mg) in the three groups, including children with hypercalciuric with and without renal stones and the healthy children (control group), was 0.44 ± 0.14, 0.39 ± 0.13, and 0.19 ± 0.08, respectively, which showed a significant difference (P < .001). There was also a significant difference in Ca/Cit ratio between the first and the control group by Tukey's range test (P < .001). Mean urinary Ca/Cit ratio in those with a positive family history of urolithiasis within three groups was 0.42 ± 0.17 and in those with a negative family history was 0.32 ± 0.16 (P = .013). Mean Ca/Cit. ratio (mg/mg) of 0.25 showed a sensitivity of 90.6% (confidence interval: 75.7-96.7%) and a specificity of 81.2% (confidence interval: 64.7-91.1%) to differentiate between the renal stone group and the control group. CONCLUSION High Ca/Cit ratio can predict stones formation in hypercalciuric patients, especially in those with a positive family history of urolithiasis. The present study found the cutoff level of 0.25 for Ca/Cit. ratio as the highest prognostic value for renal stone formation.

Background and aims: Enuresis is one of the most common disorders and problematic. Diagnosis of enuresis occurs when the urine is given 2 times in a week, for at least 3 consecutive months. This study was performed to compare the effectiveness of medicinal and non-medicinal therapy to control primary nocturnal enuresis of school-age children. Methods: This study is the one blind clinical trial which has been done on 64 children suffering from enuresis in the 6-12-year-old children in school-age reffered to the Urology Specialized Clinic in Golestan hospital, Ahvaz Jundishapur University of Medical Sciences. Children were divided parochial randomized in two groups of medicinal therapy (n=32) and non-medicinal therapy (n=32). Data collection tools include demographic questionnaire, diary note and check list. The data analysis was used from descriptive and inferential statistical tests(T-test and K2) and SPSS software. Results: The results of the present study showed that the level of improvement during intervention (one and two months) had a statistically significant difference between two groups, pharmacological and non-medicinal treatment groups (P=0.001, P=0.005), respectively. Recovery level in the group of medicinal therapy was higher than the non-medicinal treatment one. After three months from the start intervention stage, statistically significant difference was not observed between two groups (P=0.112); But in the stage of one month after the end of intervention, statistically significant difference was observed between the two groups of medicinal and non-medicinal treatment and the rate of improvement was higher in the non-medicinal al therapy (P=0.009). Conclusion: Due to the effect of duration on the results of the present study, effectiveness of non-medicinal therapy has been more than medicinal therapy. So, it is recommended, non-medicinal therapy in order to effect on the enuresis control of children to be performed in the longer term and continuous follow-up.

Background: Urinary tract infection is a common infectious disease in children and associated with the risk for renal scarring and long-term complications, usually consists of pyelonephritis and may cause complications such as scars in kidney, hypertension and renal failure. Some studies demonstrated association between urinary tract infection and electrolyte disturbances such as hyponatremia. The present study has been designed for assessment of association between urinary tract infection and hyponatremia in children. Methods: This is a descriptive, cross-sectional study has been conducted on 120 children have referred to the Golestan Hospital, Ahvaz Jundishapur University of Medical Science from 21 March 2011 until 20 March 2013. A total of 120 children who were aged 6 months to 12 years and had febrile urinary tract infection. The study population and were classified into two group of sixty children: hyponatremic and nonhyponatremic. We compared the laboratory findings in two groups with each other. The data included serum sodiom level, white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and ddimercaptosuccinic acid (DMSA) scan results collected from children with febrile urinary tract infections admitted in pediatric ward. Data analysis was performed using descriptive statistics, chi-square and independent T-test with SPSS software, ver. 20 (IBM, Armonk, NY, USA). Results: In this study, 120 patients, 104 females (86.7%) and 16 males (13.3%) aged six months to 12 years were evaluated. All the patients were studied in terms of positive DMSA Scan. In the first group (hyponatremic) 31, and the second group (without hyponatremia) 13 patients were identified. There was a significant association between hyponatremia and WBC count, ESR, CRP, duration of fever and abnormal DMSA scan. Conclusion: We conclude that there is significant association between hyponatremia and severity of urinary tract infection in children.

Many clinical studies have confirmed Procalcitonin (PCT) as a specific inflammatory marker in sepsis and bacterial infections. It is believed that PCT level is increased in various noninfectious conditions such as acute pancreatitis, major surgery, trauma and active autoimmune disease. In recent studies increased levels of serum PCT was distinguished in several kidney diseases like pyelonephritis, vesicoureteral reflux, kidney transplantation and hemodialysis. The aim of this review is to describe usefulness of PCT and practical aspect of this biomarker in nephrology field. Keywords: Procalcitonin; Biomarker; Pyelonephritis; Kidney Diseases; Kidney Transplantation; Vesico-Ureteral reflux.

Introduction: Normal values of urinary mineral excretion differ in different geographic parts. The aim of this study was to determine age-related reference intervals for urinary minerals in healthy children in the south-west of Iran. Materials and Methods : Midstream non-fasting urine samples were collected and the amount of calcium, oxalate, uric acid, phosphate, magnesium, citrate, and creatinine was measured in all urine samples. The urinary mineral concentrations were reported as mineral to creatinine ratios (mg/mg). Data were analyzed by SPSS software version 16 and independent t-test and T-Hoteling test was used. Results: The study involved 232 children aged 7 to 10 years. The 5 th and 95 th percentile values of urinary minerals to creatinine ratios were determined. The mean urinary Ca/Cr ratio was 0.14± 0.18 with a 95 th percentile value of 0.295. For oxalate to creatinine ratio, the mean value was 0.068± 0.09 mg/mg with a 95 th percentile value of 0.23. The mean uric acid to creatinine ratio was 0.358±0.211 mg/mg with an upper 95 th percentile value of 0.69 and the mean Ph/Cr ratio was 0.439 and the 95 th percentile was 1.01 mg/mg. Conclusions: We found out that the normal values of random urinary mineral to creatinine ratio differ in our region from the other countries and even from the other regions in Iran. We concluded that child's age and ethnicity should be taken into consideration when assessing the urinary mineral to creatinine ratio. Keywords : Urine Specimen Collection ; Urine minerals; Child; Iran; Calcium; Oxalate; Citrate; Uric Acid; Phosphate. Normal 0 false false false EN-US X-NONE AR-SA /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Times New Roman; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;}

Background: Enuresis is the inability to control urination during sleep. It is one of the most common childhood urologic disorders. Nocturnal enuresis refers to the occurrence of involuntary voiding at night after 5 years. Persistent nocturia can decrease self-esteem, increase anxiety and other emotional problems in children. The aim of this study is to evaluate the factors affecting nocturia amongst school-aged children. Methods: This cross- sectional study was conducted on 200 children over a period of 3 months from 21 April to 22 July 2014 ). Subjects of this study included 200 children (100 boy and 100 girl) aged 6 to 12 years that referred to the urology clinic. Following the written consent, patients under study were divided into two groups according to gender. A questionnaire concerning the personal data was completed for each patient. Questionnaires were completed by interviewing parents. Results: Our investigation revealed that 32% of children had nocturnal enuresis. The Chi-square test demonstrated significant differences between the case and control groups in terms of gender (P= 0.002), positive family history (P= 0.004), deep sleep (P= 0.005) and high fluid intake (P= 0.00). Significant differences were not observed among enuretic children with parents' education level, income, number of family mem-bers, birth order, history of injury and hospitalization, birth of a new baby, moving house, problems at school and home, snoring, mouth breathing, urinary tract infections, constipation (P> 0.05). Conclusion: In order to control enuresis it seems essential to provide information about nocturia and its etiologic factors to the children and their parents by the physician. Abstract

Introduction: Diagnosis of neonatal acute kidney injury (AKI) is a difficult dilemma and there is no consensus in this regard . Based on RIFLE criteria the definition of ARF is changed lately in adult and pediatric groups. Studies to evaluate the RIFLE criteria in the definition of neonatal ARF have not been performed. The aim of this study was to determine prevalence of AKI based on old definition of ARF and RIFLE criteria separately. Materials and Methods : This descriptive study was conducted on 904 critically ill neonates. The authors determined the RIFLE criteria for each neonate based on serum creatinine and urine output at the second day of admission. The RIFLE acronym stands for risk, injury, failure, loss of kidney function and end stage renal disease . Prevalence of AKI was determined based on old definition of ARF and RIFLE criteria separately . Results: Based on RIFLE criteria, 22.5% of study group had normal renal function and 77.5% had AKI at the second day of admission. Among patients with AKI 43% met the risk, 51% the injury and about 6% the failure criterion. Based on old definition of ARF in neonates, the prevalence of ARF in our study group was 3.2%. There was a significant difference between AKI prevalence by RIFLE criteria and the former definition (P<0.001). Conclusions: The RIFLE criterion is a simple tool for the detection and classification of AKI in NICUs. Keywords : Acute Kidney Injury; Newborn Intensive Care Units; Critically Ill. Normal 0 false false false EN-US X-NONE AR-SA /* Style Definitions */ table.MsoNormalTable {mso-style-name:Table Normal; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:Calibri,sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Times New Roman; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;}

Tuberous sclerosis complex (TSC) is a multisystemic inherited autosomal dominant disease characterized by the development of hamartomas in the brain and kidneys. In about 2% of patients, polycystic kidney disease is present, which may result in different stages of renal insufficiency. Acute kidney failure has not been reported in infants with TSC. We report a female infant with TSC who was admitted to hospital with pyelonephritis, acute kidney injury, and polycystic kidney disease.

Introduction: Urinary tract infection (UTI) is one of the most common bacterial infections in childhood which can contribute to high blood pressure and renal failure later in life. There are diffident methods for evaluation of a child with UTI for differentiation of cystitis from acute pyelonephritis. One of which is measuring protein in urine. The aim of this study is to investigate the role of UTI in provoking proteinuria. Material and Methods: This is Quasi- experimental study, before and after, in patients with acute pyelonephritis in Mofid Children's Hospital during 2004-2006. All pyelonephritic patients were treated by intravenous ceftriaxone for at least for 10 days. Random urine samples were taken from all patients at the onset of admission before starting the antibiotic and at the ninth day of treatment for the evaluation of urine protein and creatinine. Results: 152 children between 1 to 2 years of age entered the study. The prevalence of proteinuria in the acute phase of pyelonephritis was 94.8%. According to our study the prevalence of proteinuria during pyelonephritis is higher in children less than 2 years old (97.3%) and 20% of patients showed nephrotic range of proteinuria. In all cases random urine samples were normal after completion of treatment (p<0.005). Conclusions: the results of this study illustrate that proteinuria has a high frequency during UTI and acute pyelonephritis. Proteinuria during pyelonephritis may be massive and in the nephrotic range but should not be the cause of concern because in the majority of cases it disappears following treatment. Keywords : Pyelonephritis; Proteinuria; Antibiotics; Child.