title: Risk factors in the development of early technetium-99m dimercaptosuccinic acid renal scintigraphy lesions during first urinary tract infection in children.
abstract: OBJECTIVE
  To establish the variables that correlate with uptake defects in dimercaptosuccinic acid (DMSA) scintigraphy performed in the acute phase of a first episode of urinary tract infection (UTI).
  
  
  METHODS
  A prospective observational study was conducted in a cohort of 158 consecutive children with a first episode of symptomatic UTI. The therapeutic delay time (TDT) was recorded. DMSA scintigraphy was performed in all children and voiding cystourethrography in 150 of them.
  
  
  RESULTS
  85% of the patients were younger than 2 y. Mean TDT was 33.5 h. The aetiological agent was Escherichia coli in 140 children. DMSA scintigraphy was normal in 81. Vesicoureteric reflux was detected in 33. After a multivariate logistic regression analysis the following variables were retained in the final model: TDT > or = 48 h, growth of bacteria other than E. coli, percentage of polymorphonuclear cells > or = 60% and C-reactive protein > or = 30 mg l(-1).
  
  
  CONCLUSIONS
  TDT > or = 48 h, bacteria other than E. coli, percentage of polymorphonuclear cells > or = 60% and CRP > or = 30 mg l(-1) influence the findings detected in the DMSA scintigraphy performed in the acute phase of a first episode of UTI.
authors.affiliation: Servicio de Pediatría, Hospital de Cabueñes, Gijón, Spain. jfernandezm@hcab.insalud.es
authors.forename: J M
authors.initials: JM
authors.lastname: Fernández-Menéndez
authors.forename: S
authors.initials: S
authors.lastname: Málaga
authors.forename: J L
authors.initials: JL
authors.lastname: Matesanz
authors.forename: G
authors.initials: G
authors.lastname: Solís
authors.forename: S
authors.initials: S
authors.lastname: Alonso
authors.forename: C
authors.initials: C
authors.lastname: Pérez-Méndez
mesh_terms: D000208:Acute Disease; D015331:Cohort Studies; D004927:Escherichia coli Infections / Q000150:complications; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000009:adverse effects*; D012307:Risk Factors; D019783:Technetium Tc 99m Dimercaptosuccinic Acid / Q000009:adverse effects*; D013997:Time Factors; D014055:Tomography, Emission-Computed; D014552:Urinary Tract Infections / Q000175:diagnosis* / Q000382:microbiology; D014718:Vesico-Ureteral Reflux / Q000139:chemically induced*
chemical_list: D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid