Acute pyelonephritis and sequelae of renal scar in pediatric first febrile urinary tract infection

Springer Science and Business Media LLC - Tập 18 Số 4 - Trang 362-365 - 2003
Lin, Kuang-Yen1, Chiu, Nan-Tsing2, Chen, Mei-Ju3, Lai, Ching-Horng4, Huang, Jeng-Jong5, Wang, Yu-Tai6, Chiou, Yuan-Yow6,7,8
1Department of Pediatrics, Chi-Mei Foundation Hospital, Tainan, Taiwan
2Department of Nuclear Medicine, National Cheng Kung University Medical Center and College of Medicine, Tainan, Taiwan
3Department of Nursing, Chung Hwa Institute of Technology, Tainan, Taiwan
4Department of Pediatrics, China Medical College Hospital, Taichung, Taiwan
5Department of Internal Medicine, National Cheng Kung University Medical Center and College of Medicine, Tainan, Taiwan
6Department of Pediatrics, National Cheng Kung University Medical Center and College of Medicine, Tainan, Taiwan
7Institute of Clinical Medicine, National Cheng Kung University Medical Center and College of Medicine, Tainan, Taiwan
8Department of Pediatrics and Institute of Clinical Medicine, National Cheng Kung University Medical Center, Taiwan

Tóm tắt

To investigate the incidence of acute pyelonephritis (APN) and renal scarring in children with febrile urinary tract infection (UTI), 191 of 216 (88%) children with their first episode of UTI received 99mTc-dimercaptosuccinic acid renal single-photon emission computed tomography. They were investigated within 7 days of admission and were followed for 6 months. One hundred and six patients (49.1%) underwent a voiding cystourethrogram. The incidence of vesicoureteric reflux (VUR) in group I (≤1 year old) was 22%, group II (1–5 years old) 69%, and group III (5–17 years old) 44%. The overall incidence of APN in febrile UTI was 70% (male 66%, female 76%, P=0.110). Children had a higher incidence of APN than infants (P<0.05 in group I vs. II and group I vs. III). Of patients with APN, 57% (35/61) showed renal scar formation. VUR was found in 31%(24/78) of children with APN and 58% (14/24) of children with renal scar. In addition, children with high-grade VUR were more susceptible to APN and scar formation than those with low-grade VUR (P<0.05). Older children with a first febrile UTI had a higher incidence of APN than infants (≤1 year), and half of the children with APN developed a renal scar.

Tài liệu tham khảo

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