Animal studies suggest that administration of
vitamin A to rats with experimental
urinary tract infection decreases the frequency of renal
scars (Kavukçu et al., BJU Int 83(9):1055-1059, 1999). The aim of this study was to determine the effect of
vitamin A on the rate of permanent renal damage in children with acute
pyelonephritis. Fifty children, median age of 24 months (range 2-144), with first-time
pyelonephritis verified by an uptake defect on acute
dimercaptosuccinic acid (
DMSA) scan were included in the study and randomly allocated to the case or control groups. All were given intravenous
ceftriaxone for 10 days followed by oral
cephalexin for 3 months. Cases in addition were given a single intramuscular dose of
vitamin A, 25,000 U for infants below 1 year of age and 50,000 U for older children. At the repeat
DMSA scan after 3 months, five of 25 cases (20%) and 17 of 25 controls (68%) had abnormal findings (p = 0.001). In conclusion, administration of
vitamin A was associated with a significantly lower rate of permanent renal damage.