[Urinary tract infections and vesicoureteral reflux as a cause of renal parenchymal damage]. / Infekcija urinarnog trakta i vezikoureteralni refluks kao uzrok renalnog parenhimnog ostecenja.

ABSTRACT

GOAL Infection of the urinary tract is a risk for the damage of parenchyma and kidney function. Dimercaptosuccinil acid (DMSA) scan was used based on the relation between vesicoureteral reflux (VUR), infection of the urinary tract (UTI) and parenchymal kidney damage. METHODOLOGY: The number of observed children was 79, 58 (73.41%) girls and 21 (26.58%) boys following the first UTIs, recidiv infect and with positive VUR contrast voiding cistourethrography (VCUG) and ultrasound tests were compelted following the treatment of infect within 6 weeks and DMSA within 4 months. The classification of VUR was done of I to V degrees. The damage to the renal parenchyma after DMSA was defined as inhomogen distribution, reduced bonding with radio-farmake as well as portion of the kidney in the overall renal function smaller than 45%. RESULTS: Among 45.56% (36/79) patients VUR was registered. Reflux over III/V was registered among 27.84 (22/79) among whom 24.05% (19/79) were younger than 5 years of age. DMSA scan showed reduced kidney function bellow 45%, in one direction 33.33% (12/36) and 25.00% (9/36) in both directions. The correlation between clinically proved acute pielonephrities and damage to the parenchyma was not proven. It was proven in 30.37% (24/79) reoccurring urinal infection. CONCLUSION: DMSA is a sensitive method that should not be routinely used on every child with urinary infection. It should be left to assess the renal damage in cases of high degree reflux and reoccurring urinary infection.