Is omitting post urinary-tract-infection renal ultrasound safe after normal antenatal ultrasound? An observational study.
BACKGROUND
Guidelines recommend obtaining a renal ultrasonogram (RUS) for young children after a first urinary tract infection (UTI).


OBJECTIVE
The aim of the current study was to assess the concordance of prenatal and post-UTI RUS findings in children with a first simple UTI.


METHODS
This was a prospective study and included all children aged 5 years or younger who were hospitalised with a first simple UTI (determined as clinical response and normalisation of temperature within 48 h on initiation of antibacterial therapy with no complications). Data were collected from each child regarding the results of prenatal and post-UTI RUS.


RESULTS
Overall, 250 children were included in the study and the results of late-pregnancy and post-UTI RUS were available for 84% (n = 209). Complete concordance between the two RUS was demonstrated in 96% (n = 201). The predictive value of normal antenatal to normal post-UTI RUS was 96% (95% CI: 93% to 99%). These results include four children with mild transient pelvic dilatation. In eight children in whom renal anomalies were demonstrated only in post-UTI RUS, the influence of these anomalies on the children's management was negligible.


CONCLUSIONS
Prenatal-RUS have been performed in most children <5 years old hospitalised with a first simple UTI. Concordance with post-infection tests is very high. Findings which appear only in post-infectious RUS usually have negligible effects on children's management. Thus, in such children with normal antenatal RUS omitting post-UTI RUS could be considered.
Miron
Dan
D
Pediatric Department A, HaEmek Medical Center, Afula, Israel. miron_da@clalit.org.il
Daas
Ahmed
A
Sakran
Waheeb
W
Lumelsky
Dimitry
D
Koren
Ariel
A
Horovitz
Yoseph
Y
D002675:Child, Preschool; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging* / Q000196:embryology; D008297:Male; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal; D019564:Unnecessary Procedures; D014552:Urinary Tract Infections / Q000000981:diagnostic imaging*