Abstract
Our aim is to determine the rational usage of imaging techniques in order to prevent or minimize permanent renal damage in recurrent urinary tract infections (UTIs). This study was enrolled children aged between 2 and 36 months, following-up with the diagnosis of recurrent UTI. All children had ultrasonography (USG) and dimercaptosuccinic acid scanning, 39 of them had underwent on voiding cystourethrography. There were 133 children (87 girls, 46 boys) with the mean age of 32.82 ± 38.10 months included into the study. Forty-three kidney units were normal in ultrasonogram of which seven units had reflux whereas among 35 units with hydronephrosis 22 units had reflux. Sensitivity and specificity presence of hydronephrosis in ultrasonogram for prediction of reflux was 75.9% and 73.5%, respectively. There were 19 dilated ureters in ultrasonogram, and among them 14 had reflux. Sensitivity and specificity of presence with ureteral dilatation in ultrasonogram for prediction of reflux was found as 48.3% and 89.8%, respectively. The sensitivity of parenchymal thinning seen in ultrasonogram for the evaluation of renal parenchyma was 15.9%, whereas specificity was 98.2% .Sensitivity and specificity of dimercaptosuccinic acid for prediction of reflux was 51.6% and 72.3%, respectively. The normal ultrasonogram findings cannot rule out neither possibility of reflux presence nor development of renal scarring. Therefore, DMSA scanning has major role both in determination of parenchymal damage and prevention of scarring. Also we get an important result as ureteral dilatation seen in USG, related to presence of reflux.
Highlights
IntroductionUpper urinary tract infections (UTIs) (pyelonephritis) can lead to renal damage, hypertension, and end stage renal disease in future.[1] It is more difficult to differentiate cystitis or pyelonephritis clinically, in cases under two years of age
Urinary tract infection (UTI) is one of the major clinical problems in childhood
The number of febrile UTI episodes was higher in the first year for boys (Table 1)
Summary
Upper UTI (pyelonephritis) can lead to renal damage, hypertension, and end stage renal disease in future.[1] It is more difficult to differentiate cystitis or pyelonephritis clinically, in cases under two years of age. The frequency of VUR is approximately 1% in the general population whereas it raises up to 30–50% in children with recurrent UTI.[5] presence of reflux must be investigated in especially recurrent UTIs.[6] A number of guides have been published to demonstrate the risk factors that can lead to renal damage in UTIs. The early diagnosis and appropriate treatment of the disease is important for the renal damage risk in future. Diagnostic imaging method is the proposed approach in the first febrile UTI, there are debates about which is the most appropriate approach.[3,4,7,8] The purpose of this study is to determine the rational use of imaging techniques in order to prevent or to minimize permanent renal damage in recurrent UTIs
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
