Permanent renal parenchymal defects after febrile UTI are closely associated with vesicoureteric reflux |
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Authors: | Cesare Polito Pier Francesco Rambaldi Giuseppe Signoriello Luigi Mansi Angela La Manna |
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Institution: | (1) Department of Pediatrics, Second University of Naples, Naples, Italy;(2) Department of Radiological Sciences, Nuclear Medicine, Second University of Naples, Naples, Italy;(3) Department of Public Health, Second University of Naples, Naples, Italy;(4) Clinica Pediatrica, Via L. De Crecchio 2, 80138 Naples, Italy |
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Abstract: | The finding of scintigraphic renal defects in children with febrile urinary tract infection (UTI) even in the absence of vesicoureteric
reflux (VUR) has led to the conclusion that VUR is a weak predictor of renal defects in these patients. We used isotopic cystography
(IC) for diagnosis of VUR in children with febrile UTI. Dimercaptosuccinic acid renal scintigraphy was performed 6 months
after cure of the last UTI. Renal defects were defined by the finding of focal defects of radionuclide uptake and/or by a
split renal function <43%. The study included 206 children with primary VUR and 77 without VUR. Among the subjects with and
without VUR, respectively, renal defects were found in 40 and 6% (p=0.0001), focal uptake defects in 33 and 5% (p=0.0001) and split renal function <43% in 26 and 5% (p=0.0001). Permanent renal defects in children with febrile UTI are closely associated with VUR. The possibility that a child
will have permanent renal defects can reasonably be ruled out on the basis of the absence of VUR by IC. |
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Keywords: | Vesicoureteric reflux DMSA scintigraphy Renal defects Urinary infection Isotopic cystography |
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