Lack of correlation of P blood group phenotype and renal scarring.

Renal scarring is in most instances caused by infection in the young child. The most commonly occurring etiological agent in urinary tract infections is Escherichia coli. An important virulence factor for these nephropathogenic E. coli is the ability to adhere to urinary tract epithelium. This adhesion is often mediated by P-fimbriae, which recognize and specifically bind to the receptor structure (alpha-D-Galp-(1-4)beta-D-Galp) present on the cell membranes of human urinary tract epithelium. This carbohydrate structure occurs as an entity of the glycosphingolipids that correspond to the antigens of the human P blood group system. It has been proposed recently that children with recurrent acute pyelonephritis have a higher frequency of the P1 blood group phenotype than the expected 75%. We have studied 56 adult female patients with a history of febrile urinary tract infection and signs of renal scarring on urogram. The P blood group phenotype was determined in all patients. There was no increase of the P1 blood group phenotype in the patients with verified renal scarring. In conclusion, our results do not support a role of the P1 blood group phenotype in the pathogenesis of renal scarring due to previous febrile urinary tract infection.