Recurring UTIs in children, nephrologist explains how they can hurt your child’s kidneys

Health risks of urinary tract infection in children: Many children with recurring infections have a condition called Vesicoureteral Reflux (VUR), or a ‘faulty valve’. This allows urine to flow backward from the bladder toward the kidneys (Image: Canva)

When your child complains that it hurts to pee, you know it is Urinary tract infection (UTI). You take them to the doctor, give them antibiotics, and the infection clears. However, for many children the problem may soon return.

Recurrent UTIs are not just an inconvenience. Dr Udit, Nephrologist, Indian Spinal Injuries Centre,  New Delhii, tells Moneycontrol, “Recurring UTIs are a silent alarm that the kidneys may be at risk.” UTIs, he adds, start in the urinary system, often showing as nothing more than a fever or irritability in children.

However, in some cases, the body’s plumbing is not quite right. “Many children with recurring infections have a condition called Vesicoureteral Reflux (VUR), or a ‘faulty valve’. This allows urine to flow backward from the bladder toward the kidneys. Instead of urine moving out safely, it can carry bacteria back into the kidneys, turning a simple bladder infection into a much more dangerous kidney infection called pyelonephritis,” Dr Udit explains.

Additionally, when a kidney gets infected, the body launches a fierce inflammatory response. “While this fights the bacteria, it can also damage delicate kidney tissue. Every time this happens, the kidney heals with a scar. It’s like the scar you see on your skin after a deep cut—but this is non-functional tissue inside the kidney," Dr Udit says.

Repeated infections mean repeated scarring. Over time, functional kidney tissue is replaced by scar tissue, setting the stage for serious complications:

• High blood pressure (hypertension)
• Chronic kidney disease (CKD)
• Lifelong vulnerability to infections

Children with spinal cord or neurogenic problems, like spina bifida, are especially at risk. “Their bladders may not empty properly, leaving behind urine that becomes a breeding ground for bacteria. This makes the cycle of infection and scarring even more likely,” says Dr Udit.

Never dismiss a child’s UTI as ‘just a UTI’, warns Dr Udit. “Recurrent infections need careful attention. Parents should discuss repeated infections with their pediatrician, who may recommend scans like a kidney and bladder ultrasound to check for VUR or other structural issues,” he says.

Early detection and proper management are the keys to safeguarding tiny kidneys. “We are no longer just treating infections. We are actively preventing a lifetime of kidney damage,” he concludes.

UTIs in children often present as pain or discomfort while urinating, fever, irritability, or unusual urine odour.

Recurrent UTIs can occur due to conditions like Vesicoureteral Reflux (VUR), where a faulty valve causes urine to flow backward from the bladder towards the kidneys, leading to repeated infections.

Repeated UTIs can cause kidney scarring, leading to high blood pressure, chronic kidney disease, and a lifelong vulnerability to infections.

Parents should take recurrent UTIs seriously and discuss them with a paediatrician. Early detection and management, including scans for structural issues, can help protect children’s kidney health.

Children with conditions like spina bifida may have bladders that do not empty properly, creating an environment where bacteria can thrive, increasing the risk of recurrent infections and kidney damage.