HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Imaging strategy for infants with urinary tract infection: a new algorithm.

AbstractPURPOSE:
We analyzed clinical data for prediction of permanent renal damage in infants with first time urinary tract infection.
MATERIALS AND METHODS:
This population based, prospective, 3-year study included 161 male and 129 female consecutive infants with first time urinary tract infection. Ultrasonography and dimercapto-succinic acid scintigraphy were performed as acute investigations and voiding cystourethrography within 2 months. Late scintigraphy was performed after 1 year in infants with abnormality on the first dimercapto-succinic acid scan or recurrent febrile urinary tract infections. End point was renal damage on the late scan.
RESULTS:
A total of 270 patients had end point data available, of whom 70 had renal damage and 200 did not. Final kidney status was associated with C-reactive protein, serum creatinine, temperature, leukocyturia, non-Escherichia coli bacteria, anteroposterior diameter on ultrasound and recurrent febrile urinary tract infections. In stepwise multiple regression analysis C-reactive protein, creatinine, leukocyturia, anteroposterior diameter and non-E.coli bacteria were independent predictors of permanent renal damage. C-reactive protein 70 mg/l or greater combined with anteroposterior diameter 10 mm or greater had sensitivity of 87% and specificity of 59% for renal damage. An algorithm for imaging of infants with first time urinary tract infection based on these results would have eliminated 126 acute dimercapto-succinic acid scans compared to our study protocol, while missing 9 patients with permanent renal damage.
CONCLUSIONS:
C-reactive protein can be used as a predictor of permanent renal damage in infants with urinary tract infection and together with anteroposterior diameter serves as a basis for an imaging algorithm.
AuthorsIulian Preda, Ulf Jodal, Rune Sixt, Eira Stokland, Sverker Hansson
JournalThe Journal of urology (J Urol) Vol. 185 Issue 3 Pg. 1046-52 (Mar 2011) ISSN: 1527-3792 [Electronic] United States
PMID21247606 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Chemical References
  • Radiopharmaceuticals
  • Technetium Tc 99m Dimercaptosuccinic Acid
Topics
  • Algorithms
  • Female
  • Humans
  • Infant
  • Kidney Diseases (diagnosis, diagnostic imaging, etiology)
  • Male
  • Predictive Value of Tests
  • Prospective Studies
  • Radionuclide Imaging
  • Radiopharmaceuticals
  • Technetium Tc 99m Dimercaptosuccinic Acid
  • Ultrasonography
  • Urinary Tract Infections (complications)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: