title: Is omitting post urinary-tract-infection renal ultrasound safe after normal antenatal ultrasound? An observational study.
abstract: 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.
authors.affiliation: Pediatric Department A, HaEmek Medical Center, Afula, Israel. miron_da@clalit.org.il
authors.forename: Dan
authors.initials: D
authors.lastname: Miron
authors.forename: Ahmed
authors.initials: A
authors.lastname: Daas
authors.forename: Waheeb
authors.initials: W
authors.lastname: Sakran
authors.forename: Dimitry
authors.initials: D
authors.lastname: Lumelsky
authors.forename: Ariel
authors.initials: A
authors.lastname: Koren
authors.forename: Yoseph
authors.initials: Y
authors.lastname: Horovitz
mesh_terms: 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*