Asymptomatic Bacteriuria -a Hidden Cause of Renal Insufficiency

Abstract

Asymptomatic bacteriuria is a bacterial urinary tract infection (UTI) that occurs without any of the usual symptoms. Repeated urinary tract infections may be associated with renal insufficiency and increased mortality in adults¹. Asymptomatic bacteriuria may precede symptomatic urinary tract infectio² Urinary tract infection may be associated with renal insufficiency and increased mortality in adults, but these complications rarely occur among those without underlying structural and functional diseases of the urinary tract¹. The risk of acquiring bacteriuria varies with age and sex. Bacteriuria occurs in 2-7% of pregnant women; of those who are not bacteriuric at initial screening, 1-2% will develop bacteriuria later in the pregnancy^13-15. In children, asymptomatic bacteriuria may be a sign of underlying urinary tract abnormalities. Children with major structural abnormalities, chronic pyelonephritis or severe vesicoureteral reflux are at increased risk of renal scarring, obstructive renal atrophy, hypertension, and renal insufficiency¹. In pregnancy, 13-27% of untreated women with asymptomatic bacteriuria develop pyelonephritis, usually requiring hospitalization for treatment^22-25. Individuals in high-risk groups have a significant risk of progressing to a true kidney infection if the bacteriuria is not treated. Asymptomatic bacteriuria eventually progresses to a full-blown UTI with the usual symptoms, in some individuals. Asymptomatic bacteriuria can be prevented by drinking several glasses of water each day and drinking juices or medications that acidify the urine. The prevalence of bacteriuria, whether symptomatic or asymptomatic, is not well documented in Nigeria and a high index of suspicion is advised.