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November 1977

Priorities in the Prevention of Pyelonephritis

Author Affiliations

From the Medical Service, William S. Middleton Memorial Veterans Administration Hospital and the Department of Medicine, University of Wisconsin School of Medicine, Madison.

Am J Dis Child. 1977;131(11):1281-1282. doi:10.1001/archpedi.1977.02120240099021

There is much merit in the points raised by Dodge in his comprehensive review of the subject of screening for renal disease. It is not surprising that screening for such common phenomena as proteinuria, hematuria, and bacteriuria has not been shown to prevent end-stage renal disease. They are only laboratory findings that provide limited information about a patient. Urinary tract infections are very common particularly in female patients. It is well established that most of these infections have an excellent prognosis unless complicated by obstructive or neurologic defects in the voiding mechanism. Therefore, it follows that most infections that are detected will not produce end-stage renal failure. This is not surprising nor is it reason to abandon a useful procedure.

Urinary infections in childhood are a cause of considerable morbidity. Must we have a disease that kills people before it is considered to be important? Cost-effectiveness depends on one's point