Relationship of increased renal cortical echogenicity with clinical and laboratory findings in pediatric renal disease

PURPOSE: To correlate the clinical and laboratory findings with increased renal cortical echogenicity in children with acute renal diseases. MATERIALS AND METHODS: Children with increased renal cortical echogenicity were evaluated retrospectively. Laboratory findings and final diagnoses were reviewed. Patients with increased echogenity were classified into group 1 (mild; grade I) or group 2 (more severe; grades II and III). RESULTS: There were 7 newborns and 114 children (67 male, 47 female) with increased renal cortical echogenicity with a mean (+/-SD) age of 7.0 (+/-4.4) years. The clinical diagnosis was anatomic abnormality (including vesicoureteral reflux, ureteropelvic junction obstruction, ureterovesical junction obstruction, double collecting system) in 9%, urinary tract infection in 21%, urolithiasis in 6%, nephrotic syndrome in 20%, glomerulonephritis in 32%, and other diseases in 12%. Hyperechogenicity was bilateral in 72%, right-sided in 19%, and left-sided in 9%. There were 81 patients in group 1 and 33 patients in group 2 (grade II, 29; grade III, 4). There was no statistically significant difference between the groups with regard to age, sex, and serum blood urea nitrogen level, serum creatinine level, uric acid level, urine pH, and specific gravity. Hematuria was more frequent in group 2, whereas proteinuria and pyuria incidences were similar in the 2 groups. In patients with hematuria, glomerulonephritis was the most common cause. CONCLUSIONS: Glomerulonephritis is the most frequent acute disease causing increased renal echogenicity in childhood, and higher echogenicity is more likely to be associated with hematuria.