Abstract | PURPOSE: 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:
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Authors | Iulian Preda, Ulf Jodal, Rune Sixt, Eira Stokland, Sverker Hansson |
Journal | The Journal of urology
(J Urol)
Vol. 185
Issue 3
Pg. 1046-52
(Mar 2011)
ISSN: 1527-3792 [Electronic] United States |
PMID | 21247606
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Radiopharmaceuticals
- Technetium Tc 99m Dimercaptosuccinic Acid
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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)
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