Clinical Efficacy of a Top-down Approach for Children with a First Febrile Urinary Tract Infection
Childhood Kidney Diseases
;
: 114-120, 2017.
Artigo
em Inglês
| 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:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Sistema Urinário
/
Infecções Urinárias
/
Refluxo Vesicoureteral
/
Estudos Retrospectivos
/
Ultrassonografia
/
Cicatriz
/
Resultado do Tratamento
/
Distribuição por Idade
/
Succímero
/
Ácido Dimercaptossuccínico Tecnécio Tc 99m
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
/
Estudo prognóstico
Limite:
Criança
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Childhood Kidney Diseases
Ano de publicação:
2017
Tipo de documento:
Artigo
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