Clinical Efficacy of a Top-down Approach for Children with a First Febrile Urinary Tract Infection
Childhood Kidney Diseases
;
: 114-120, 2017.
Artículo
en Inglés
| WPRIM
| ID: wpr-136725
ABSTRACT
PURPOSE:
The aim of this study was to determine the clinical characteristics, frequency of renal abnormalities and benefits of a top-down approach in children with their first febrile urinary tract infection (UTI).METHODS:
We reviewed 308 patients retrospectively who were admitted to Yeungnam University Hospital and were treated for their first febrile UTI from February 2006 to December 2013. We performed a comparative analysis of laboratory findings and results of imaging techniques including a Tc-99m dimercaptosuccinic acid (DMSA) renal scan.RESULTS:
Among the patients, 69% (213/308) were males, and 90% (277/308) had their first UTI episode during infancy. A DMSA renal scan was performed on all patients, and showed positive findings in 60% (184/308) of cases. Laboratory indices of inflammation were significantly higher in the DMSA-positive group (P<0.05). There was a statistically significant difference in the age distribution between the two groups. In the DMSA-positive group, 165 patients underwent voiding cystourethrography (VCUG), and 58 (35%) cases demonstrated vesicoureteral reflux. In total, 110 patients in the DMSA-positive group, underwent repeat scanning at 6 months; 33 children (30%) demonstrated static scarring, but 77 (70%) had improved completely. The concordance of the ultrasonography (US) and VCUG was low. Older patients had more renal scarring.CONCLUSION:
DMSA is a sensitive method for assessing the severity of inflammation and kidney injury. However, the ability of US to predict renal parenchymal damage was limited. A top-down approach in children with their first febrile UTI showed significant value.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Sistema Urinario
/
Infecciones Urinarias
/
Reflujo Vesicoureteral
/
Estudios Retrospectivos
/
Ultrasonografía
/
Cicatriz
/
Resultado del Tratamiento
/
Distribución por Edad
/
Succímero
/
Ácido Dimercaptosuccínico de Tecnecio Tc 99m
Tipo de estudio:
Estudio diagnóstico
/
Estudio observacional
/
Estudio pronóstico
Límite:
Niño
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Childhood Kidney Diseases
Año:
2017
Tipo del documento:
Artículo
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