Isolated Hydronephrosis and Urinary Tract Infection by Two Years of Age: A Population-Based Study.

To evaluate the risk for urinary tract infection (UTI) in infants with isolated hydronephrosis (IH). A retrospective, population-based study including all infants insured by Clalit Health Services (CHS) and followed from birth to age 2 years in 3 regions of central Israel. Infants were divided into 3 groups based on electronic medical record (EMR) diagnoses by age 6 months: 1) control - no urological diagnosis; 2) IH; and 3) "complicated urological diagnosis" (CUD): any additional nephrological/urological diagnosis with/without HN. The primary outcome was a diagnosis of UTI in the first two years of life. The cohort included 340,619 infants (52% male): 333,920 controls group, 4,369 with IH, and 2,331 with CUD. IH was associated with a higher risk for UTI compared with controls (17% vs. 4%, p<0.001). UTI risk for a male with IH was higher than for a female in the control group (12.6% vs 6.5%, p< 0.001). In a multivariable logistic regression analysis, both IH (OR 7.04, 95% CI: 6.46-7.66) and CUD (OR 14.9, 95% CI: 13.6-16.4) were independently associated with UTI. Infants with IH are at a higher risk for UTI in the first 2 years of life, supporting the recommendation for a high index of suspicion for UTI in this population.

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