Relationship between acute pyelonephritis, renal scarring, and vesicoureteral reflux |
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| Authors: | Pilar Orellana Paulina Baquedano Venkatesh Rangarajan Jin Hua Zhao Ng David Chee Eng Jurij Fettich Tawatchi Chaiwatanarat Kerim Sonmezoglu Dilip Kumar Yung Ha Park Aban Meyer Samuel Rune Sixt Veereshwar Bhatnagar Ajit K Padhy |
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| Institution: | (1) Nuclear Medicine Section, School of Medicine, Catholic University of Chile, Marcoleta 347, Santiago, Chile;(2) Department of Pediatric Urology, School of Medicine, Catholic University of Chile, Santiago, Chile;(3) Radiation Medicine Center (BARC), Mumbai, India;(4) Nuclear Medicine Section, Shanghai Medical University, Hua Shan Hospital, China;(5) Nuclear Medicine Section, Singapore General Hospital, Singapore;(6) Nuclear Medicine Section, University Medical Centre, Slovenia;(7) Department of Radiology, Faculty of Medicine, Chulalongkorn University, Thailand;(8) Department of Nuclear Medicine, Cerrahpasa Medical Faculty, Istanbul University, Turkey;(9) All India Institute of Medical Sciences, New Delhi, India;(10) Department of Radiology and Nuclear Medicine, St. Vincent s Hospital, Catholic University of Korea, Korea;(11) Department of Pediatric Clinical Physiology, The Queen Silvia Childrens Hospital, Sweden;(12) Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India;(13) International Atomic Energy Agency, Austria |
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| Abstract: | Acute pyelonephritis (APN) may produce permanent renal damage (PRD), which can subsequently lead to diverse complications. We prospectively evaluated 147 females and 122 males (mean age 3.5 years) with APN in order to analyze the relationship between the presence of PRD, at the time of cortical renal scintigraphy, and age, gender, episodes of urinary tract infection (UTI), and presence of vesicoureteral reflux (VUR). There were 152 children studied after the first proven UTI. VUR was present in 150 children. PRD was observed in 170 children. There were no significant differences between boys and girls. PRD was found in 36.4% of children younger than 1 year and in 70.1% of those older than 1 year (P<0.0001). Of children with VUR, 72% had PRD compared with 52% of children without VUR (P<0.0001). Of children with a first episode of UTI, 55.9% developed PRD as did 72.6% of those with recurrent UTI (P=0.004). Our results showed that PRD in children with APN is important, especially in the presence of VUR, recurrent UTI, and older age. |
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| Keywords: | Acute pyelonephritis Renal scarring Vesicoureteral reflux Renal scintigraphy |
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