New renal scarring in children who at age 3 and 4 years had had normal scans with dimercaptosuccinic acid: follow up study.
BMJ
; 315(7113): 905-8, 1997 Oct 11.
Article
em En
| MEDLINE
| ID: mdl-9361538
ABSTRACT
OBJECTIVE:
To determine up to what age children remain at risk of developing a new renal scar from a urinary tract infection.DESIGN:
Follow up study. Families of children who had normal ultrasound scans and scanning with dimercaptosuccinic acid (DMSA) after referral with a urinary tract infection when aged 3 (209) or 4 (220) were invited to bring the children for repeat scans 2-11 years later. A history of infections since the original scan was obtained for children not having a repeat scan.SETTING:
Teaching hospital.SUBJECTS:
Children from three health districts in whom a normal scan had been obtained at age 3-4 years in 1985-1992 because of a urinary tract infection. MAIN OUTCOMEMEASURE:
Frequency of new renal scars in each age group.RESULTS:
In each group, about 97% of children either had repeat scanning (over 80%) or were confidently believed by their general practitioner or parent not to have had another urinary infection. The rate of further infections since the original scan was similar in the 3 and 4 year old groups (48/176 (27%)) and 55/179 (31%)). Few children in either group known to have had further urinary infections did not have repeat scanning (3/209 (1.4%) and 4/220 (1.8%)). In the 3 year old group, 2.4% (5/209) had one or more new kidney scars at repeat scanning (one sided 95% confidence interval up to 5.0%), whereas none of the 4 year olds did (one sided 95% confidence interval up to 1.4%). The children who developed scars were all aged under 3.4 years when scanned originally.CONCLUSIONS:
Children with a urinary tract infection but unscarred kidneys after the third birthday have about a 1 in 40 risk of developing a scar subsequently, but after the fourth birthday the risk is either very low or zero. Thus the need for urinary surveillance is much reduced in a large number of children.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Infecções Urinárias
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Cicatriz
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Succímero
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Nefropatias
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Child
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Child, preschool
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Humans
Idioma:
En
Revista:
BMJ
Ano de publicação:
1997
Tipo de documento:
Article