The Effect of Vitamin A and Corticosteroid in Reducing Kidney Scars in Children with Acute Pyelonephritis: A Clinical Trial Study

Background & Objective: To investigate the effect of vitamin A and Corticosteroid in reducing kidney scars in children with acute Pyelonephritis (PN). Materials & Methods:This clinical trial study was conducted on 45 children with acute pyelonephritis.Patients were randomly divided into three groups of vitamin A (n= 15), Corticosteroid (n= 15) and placebo (n= 15).In addition to standard treatment for all patients, the first group received vitamin A once a day and each time 25,000 units for children under one year and 50,000 units for children one year and older during 3 days of hospitalization intravenously.The second group received Corticosteroid (dexamethasone) daily 0.15 mg/kg/day in two divided doses (25) during three days of hospitalization intravenously.The placebo group received normal saline as an injection.All patients were followed up for 6 months. Results:The recovery rate of abnormal lesions in the vitamin A, Corticosteroid and placebo groups was 46.7%, 6.7% and 26.7% respectively, and this difference was statistically significant (P-Value=0.016).Also, the results of 99mTcdimercaptosuccinic acid (DMSA) before and after intervention was statistically significant only for the group receiving vitamin A, so that 46.7% of the total 66.7% patients with abnormal lesions in the first 99mTc-DMSA scan had improved after the intervention in the the second 99mTc-DMSA scan (P-Value =0.001). Conclusion:Vitamin A may be effective in reducing kidney scars in children with APN.