Cover image of the thesis. Left: Imaging algorithm from the clinical guidelines. Middle: Animation of infant with infection on the right kidney as seen on scintigraphy. Right: DNA molecule. Illustration by Hanna 尝颈苍诲茅苍.
Urinary tract infections in infants can lead to kidney damage and often require extensive examinations. Magnus 尝颈苍诲茅苍鈥檚 research contributes to more efficient management and reduces the number of children exposed to radiation.
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Magnus 尝颈苍诲茅苍, pediatrician at the Department of Pediatrics and Adolescents in Halmstad and a doctoral student at the Institute of Clinical 91探花s.
About two percent of all children under the age of one develop urinary tract infections. Fever is often the only symptom, making the diagnosis difficult to establish and confirm.
The infection can cause lasting kidney damage and sometimes, congenital anatomical abnormalities in the kidneys contribute to the infection. This is why an evaluation, often including radiological examinations, is conducted after a first urinary tract infection in infants. However, opinions differ on both how the diagnosis should be made and how extensive the examinations should be.
Magnus 尝颈苍诲茅苍 has analyzed how Swedish pediatric clinics handle these infections. In collaboration with a research group in Lund, he has also investigated genetic factors linked to the risk of developing kidney damage.
Figure from the thesis. Extent of injury in 126 infants with kidney damage after urinary tract infection. Normal relative function on each kidney is 45-55%. The lower percentage the more severe damage. Boys had more severe kidney damage than girls.
Guidelines should be revised
鈥淲e found that kidney damage and anatomical abnormalities are detected as expected, but at the cost of numerous radiological examinations. It is time to revise the guidelines to reduce the burden of testing and limit radiation exposure. My studies will serve as an important foundation for this work,鈥 says Magnus 尝颈苍诲茅苍, who is a pediatrician at the Department of Pediatrics and Adolescents in Halmstad and a doctoral student at the Institute of Clinical 91探花s.
Improved routines can help healthcare providers better determine which infants actually require extensive examinations and which can be monitored in other ways. Finding this balance is one of the major challenges.
What did the study on the connection between genetic factors and kidney injury reveal? 鈥淚t showed that a genetic profile consisting of variations in a large group of genes could predict which children developed kidney injury. So far, the analysis is too complex for clinical use. However, our results may contribute to the ongoing and important search for better risk markers for kidney injury.鈥
Figure from the thesis. A genetic profile separates infants with persistent kidney damage after a kidney infection from those with resolved infection.
Challenges of studying infants
What have been the most rewarding aspects of your doctoral project? 鈥淐ollaborating with colleagues across the country has been incredibly rewarding and has helped me build a strong professional network. Throughout the project, I have also gained extensive knowledge about infections and kidney diseases, which will be highly useful in my clinical work,鈥 says Magnus 尝颈苍诲茅苍.
And the most challenging? 鈥淪tudying acutely ill infants while addressing parents鈥 concerns has been a challenge. I have gained a deep respect for the complexities involved in conducting research on young children.鈥