Clinical Efficacy of a Top-down Approach for Children with a First Febrile Urinary Tract Infection
Childhood Kidney Diseases
; : 114-120, 2017.
Article
在 En
| WPRIM
| ID: wpr-136725
Responsible library:
WPRO
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.
Key words
全文:
1
索引:
WPRIM
主要主题:
Urinary Tract
/
Urinary Tract Infections
/
Vesico-Ureteral Reflux
/
Retrospective Studies
/
Ultrasonography
/
Cicatrix
/
Treatment Outcome
/
Age Distribution
/
Succimer
/
Technetium Tc 99m Dimercaptosuccinic Acid
研究类型:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
限制:
Child
/
Humans
/
Male
语言:
En
期刊:
Childhood Kidney Diseases
年:
2017
类型:
Article