Evaluation of Abnormal Radiological Findings in Children Under Five Years With Acute Pyelonephritis: A Retrospective Cohort Study
Journal of Pediatric Nephrology,
Vol. 10 No. 1 (2022),
Background and Aim: Urinary tract infection is one of the most common infections in
childhood. The disease should not be overlooked because it has long-term complications such
as renal scarring and failure. We aimed to determine the relationships between radiological
findings in children under five years with acute pyelonephritis and its long-term complications.
Methods: In this retrospective study, we reviewed the medical records of all children
hospitalized with acute pyelonephritis in a two-year period. We studied, extracted, and
analyzed the imaging and demographic data of the patients.
Results: Out of 210 available cases, 54 children with acute culture-positive pyelonephritis
were included. All the included cases had undergone ultrasound, Radionuclide Cystogram
(RNC), Voiding Cystourethrography (VCUG) (for urinary reflux), and late DMSA
(Dimercaptosuccinic Acid) scintigraphy. We found that 46.2% had Vesicoureteral Reflux
(VUR), and 57.4% had an abnormal ultrasound, with hydronephrosis being the most
common finding (74.1%). We also found a significant correlation between ultrasound and
VUR (P=0.002). About 37% also had abnormal DMSA scintigraphy. However, in those with
normal ultrasound results, 20% suffered from VUR, with one being severe. Seven cases also
had abnormal DMSA scintigraphy.
Conclusion: We demonstrated that a normal urinary ultrasound does not rule out the
possibility of VUR or the risk of progression to renal parenchymal dysfunction and scarring.
Therefore, we suggest further utilizing the available radiologic techniques to diagnose and
minimize subsequent renal complications in the disease promptly.
- Urinary tract infections
- Kidney diseases
- Vesicoureteral reflux
- Technetium Tc 99m dimercaptosuccinic acid
- Radionuclide imaging
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