title: Acute pyelonephritis and sequelae of renal scar in pediatric first febrile urinary tract infection.
abstract: To investigate the incidence of acute pyelonephritis (APN) and renal scarring in children with febrile urinary tract infection (UTI), 191 of 216 (88%) children with their first episode of UTI received (99m)Tc-dimercaptosuccinic acid renal single-photon emission computed tomography. They were investigated within 7 days of admission and were followed for 6 months. One hundred and six patients (49.1%) underwent a voiding cystourethrogram. The incidence of vesicoureteric reflux (VUR) in group I (</=1 year old) was 22%, group II (1-5 years old) 69%, and group III (5-17 years old) 44%. The overall incidence of APN in febrile UTI was 70% (male 66%, female 76%, P=0.110). Children had a higher incidence of APN than infants ( P<0.05 in group I vs. II and group I vs. III). Of patients with APN, 57% (35/61) showed renal scar formation. VUR was found in 31%(24/78) of children with APN and 58% (14/24) of children with renal scar. In addition, children with high-grade VUR were more susceptible to APN and scar formation than those with low-grade VUR ( P<0.05). Older children with a first febrile UTI had a higher incidence of APN than infants (</=1 year), and half of the children with APN developed a renal scar.
authors.affiliation: Department of Pediatrics, Chi-Mei Foundation Hospital, Tainan, Taiwan.
authors.forename: Kuang-Yen
authors.initials: KY
authors.lastname: Lin
authors.forename: Nan-Tsing
authors.initials: NT
authors.lastname: Chiu
authors.forename: Mei-Ju
authors.initials: MJ
authors.lastname: Chen
authors.forename: Ching-Horng
authors.initials: CH
authors.lastname: Lai
authors.forename: Jeng-Jong
authors.initials: JJ
authors.lastname: Huang
authors.forename: Yu-Tai
authors.initials: YT
authors.lastname: Wang
authors.forename: Yuan-Yow
authors.initials: YY
authors.lastname: Chiou
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002614:Chelating Agents; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D011704:Pyelonephritis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D004113:Succimer; D015899:Tomography, Emission-Computed, Single-Photon; D014552:Urinary Tract Infections / Q000150:complications* / Q000000981:diagnostic imaging; D014718:Vesico-Ureteral Reflux / Q000209:etiology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D002614:Chelating Agents; D004113:Succimer