title: Vesicoureteral Reflux and Renal Scarring Risk in Children after the First Febrile Urinary Tract Infection.
abstract: OBJECTIVE
  There are many controversies regarding the best approach for evaluating children after their first febrile urinary tract infection (UTI). The aim of this study was to define the clinical, laboratory, and radiological features of patients with their first febrile UTI and to investigate the factors that might predict the presence of vesicoureteral reflux (VUR) and renal scarring.
  
  
  METHODS
  The files of patients who were followed due to their first febrile UTI between 2008 and 2013 were retrospectively reviewed (n = 300). Patients were divided into groups based on their age, the resistance state of microorganisms, the presence of VUR, and scarring on Tc99m dimercaptosuccinic acid scintigraphy. The chi-square test and Mann-Whitney U test were used for analysis.
  
  
  RESULTS
  The median age at the first febrile UTI was 11 months and girls constituted 77% of the patient population. VUR and renal scarring were detected in 30.9 and 19.4% of the patients, respectively. C-reactive protein levels and the presence of renal scarring were significantly higher in patients with VUR (p < 0.05). Abnormal ultrasonography findings, VUR and recurrent UTIs were significantly higher in patients with renal scars (p < 0.001). In multivariate analysis, we did not detect any factor that might predict the presence of VUR and renal scarring.
  
  
  CONCLUSIONS
  A majority of children had their first febrile UTI at a young age. Although we could not find any factor that might predict the VUR and scar risk in patients with their first febrile UTI, an abnormal renal scan at 6 months after infection was closely related with the presence of VUR and recurrent UTIs.
authors.affiliation: Department of Pediatric Nephrology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Songül
authors.initials: S
authors.lastname: Yılmaz
authors.forename: Z Birsin
authors.initials: ZB
authors.lastname: Özçakar
authors.forename: Eda Didem
authors.initials: ED
authors.lastname: Kurt Şükür
authors.forename: Burcu
authors.initials: B
authors.lastname: Bulum
authors.forename: Aslı
authors.initials: A
authors.lastname: Kavaz
authors.forename: Atilla H
authors.initials: AH
authors.lastname: Elhan
authors.forename: Fatoş
authors.initials: F
authors.lastname: Yalçınkaya
mesh_terms: D000293:Adolescent; D000367:Age Factors; D017668:Age of Onset; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix; D024881:Drug Resistance, Bacterial; D005260:Female; D005334:Fever / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007674:Kidney Diseases / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D049268:Positron-Emission Tomography; D012008:Recurrence; D012189:Retrospective Studies; D012737:Sex Factors; D014463:Ultrasonography; D014552:Urinary Tract Infections / Q000150:complications* / Q000453:epidemiology* / Q000382:microbiology; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*
chemical_list: D002097:C-Reactive Protein