Renal damage one year after first urinary tract infection: Role of dimercaptosuccinic acid scintigraphy☆,☆☆,★,★★
Section snippets
METHODS
During a 2-year period all children from birth to age 6 years who were treated at the Children's Hospital because of culture-verified acute first-time symptomatic UTI underwent DMSA scintigraphy in association with the infection and after 1 year. A body temperature of 38.5° C or higher was required for inclusion of children aged more than 1 year, whereas younger children were included irrespective of body temperature. Children with urinary tract obstruction were excluded. One hundred
RESULTS
The results of DMSA scintigraphy 1 year after the index UTI were abnormal in 59 (38%), equivocal in 33 (21%) and normal in 65 (41%) of the children. Bilateral abnormalities were found in 6 (10%) of the 59 children; 20 (34%) of the 59 children had an abnormal split renal function.
DISCUSSION
A major clinical problem in children with UTI is the difficulty of identifying those at risk of having renal damage. We previously demonstrated the diagnostic value of various clinical and laboratory variables in the identification of renal involvement in acute UTI.10 Little is known, however, about the value of these variables in identifying patients at risk of permanent scintigraphic renal damage. We therefore studied the importance of age at infection, body temperature, CRP concentration,
Acknowledgements
Statistical analyses were performed by Anders Odén, PhD.
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From the Departments of Pediatric Radiology, Pediatrics, and Pediatric Clinical Physiology, East Hospital, and the Department of Radiology, Sahlgrenska Hospital, Göteborg University, Göteborg, Sweden
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Supported by grants from the Göteborg Medical Society, the First of May Flower Annual Campaign for Children's Health, the Medical Faculty of Göteborg University, the Swedish Medical Research Council, and the Swedish Society for Medical Research.
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Reprint requests: Eira Stokland, MD, PhD, Department of Pediatric Radiology, Children's Hospital, East Hospital, 416 85 Göteborg, Sweden.
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0022-3476/96/$5.00 + 0 9/21/76243