Kidney Week

Abstract: TH-PO1196

Association of Urinary Tract Infections with Quality of Life in Children with Congenital Anomalies of the Kidney and Urinary Tract in the CKiD Cohort

Session Information

• Pediatric Nephrology: CV Health, CKD, AKI, Dialysis, Transplantation, and Health Services Research
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1800 Pediatric Nephrology

Authors

• Gyawali, Pratyush, Children's Hospital at Montefiore, New York, New York, United States

Pratyush Gyawali, MD

• Zhang, Siyao, Johns Hopkins University, Baltimore, Maryland, United States

Siyao Zhang, MHS

• Dell, Katherine MacRae, Cleveland Clinic, Cleveland, Ohio, United States

Katherine MacRae Dell, MD

• Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States

Susan L. Furth, MD, PhD

• Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States

Bradley A. Warady, MD

• Kaskel, Frederick J., Children's Hospital at Montefiore, New York, New York, United States

Frederick J. Kaskel, MD, PhD, FASN

• Ng, Derek K., Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States

Derek K. Ng, PhD

• Reidy, Kimberly J., Children's Hospital at Montefiore, New York, New York, United States

Kimberly J. Reidy, MD

Background

Health related quality of life (HRQoL) in children with chronic kidney disease (CKD) is impaired but its association with urinary tract infections (UTI) is not well quantified. We sought to examine the association between infections and HRQoL in children with congenital abnormalities of the kidney and urinary tract (CAKUT) diagnoses and enrolled in the Chronic Kidney Disease in Children (CKiD) study.

Methods

CKiD participants with CAKUT and complete data on UTI (presence or absence) and HRQoL were included. HRQoL was calculated from the 23-item PedsQL Generic Core Scales: scores range from 0-100 with higher scores indicating better HRQoL. Repeated measures regression models quantified the association between HRQoL (outcome) and infections (exposure), adjusting for specific CAKUT diagnostic types, age, sex, eGFR, proteinuria, urinary incontinence, number of hospitalizations, and number of medications. Models were fit separately for parent and child reported HRQoL.

Results

455 participants contributed 1835 person-visits, of which 26% (n= 477) of person-visits reported an infection in the past year. The median [IQR] parent-reported HRQoL was 82 [67, 90] and 72 [59, 84] for person-visits without and with infection, respectively, with similar differences for child-reported HRQoL. In a base model adjusting for age, sex, eGFR, proteinuria and diagnoses, infection was associated with a 6.2 point lower HRQoL (95%CI: -8.8, -3.7, p<0.01) for both parent and child reported measures. In a fully adjusted model, infection was associated with a difference of -3.9 (95%CI: -6.3, -1.5) for parent reported and -4.3 (95%CI: -6.6, -1.9) for child reported HRQoL scores. Adjustment variables including urinary incontinence, recurrent hospitalizations, and higher number of medications were associated with reduced HRQoL.

Conclusion

Infections were associated with significantly lower parent- and child-reported HRQoL scores. Additional factors such as urinary incontinence, recurrent hospitalizations, and higher number of medications were also associated with poorer HRQoL. Urinary incontinence is likely a confounder but seems to have an additive effect, and number of hospitalizations and medications are likely mediators. Further work is required to determine if infection prevention measures in this high-risk population will improve HRQoL.

Funding

• NIDDK Support