Objective The aim of this study was to determine the risk factors such as age, sex, duration of fever, voiding dysfunction, constipation, history of recurrent UTI, the levels of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC), polymorphonuclear leukocytes (PNL), platelet count, mean platelet volume (MPV), serum urea, creatinine, proteinuria, type of microorganisms, presence of vesicoureteral reflux(VUR) for the development of renal damage in patients with acute pyelonephritis.
Material and Methods A total of 197 children (44 boys, 153 girls) were enrolled in the study, mean age was 4.7±4.0 years (1 month-16 years). Ultrasonography, renal cortical scintigraphy (RCS) with 99mTc-Dimercaptosuccinic acid and voiding cystourethrography were performed in all patients. The patients were grouped by age according to presumed risk of renal damage: high risk(≤1 year), moderate risk(1–5 years), and low risk (>5 years).
Results Renal lesions on RCS were detected in 91 patients. Abnormal RCS were found in 35% of infants younger than 1 year, in 57% of children between 1–5 years and in 42% of children older than 5 years. Abnormal RCS was found in 66% of the children with VUR and in 42.7% of those without VUR(p=0.005). There was a significant positive correlation between abnormal RCS and VUR, duration of fever (>2 days), history of recurrent UTI, high levels of ESR, CRP, WBC, and PNL at the presentation.
Conclusion The patients with VUR were 2.6 times more likely to have renal damage. The risk of renal damage should be considered in all age groups.