Urinary tract infections under 24 months old: Is it possible to predict the risk of renal scarring?

Detalhes bibliográficos
Autor(a) principal: Miranda,Ana M
Data de Publicação: 2017
Outros Autores: Garcia,Catarina, Bento,Vanda A, Pinto,Sara
Tipo de documento: Relatório
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000200003
Resumo: Background: Urinary tract infection is one of the most common bacterial infections in the first two years of life and it can lead to irreversible renal scarring. Renal scintigraphy is the gold standard method for detection of renal scars. The aim of our work was to revise the cases of pyelonephritis, detect the possible predictors for renal scarring and compare those results we would have obtained if we had followed current NICE guidelines. Methods: Retrospective analysis of all patients aged under 24 months evaluated in the paediatric department and diagnosed with pyelonephritis during a three-year period. We excluded the cases in which no renal scintigraphy was performed. Results: Of the 59 children analysed, 50.8% were boys and 86.4% were under one-year old. Escherichia coli was the predominant bacteria. Renal ultrasonography showed abnormal findings in 23 patients (39%). The incidence of renal scarring was 15.3%. Age, atypical urinary tract infection and abnormal renal ultrasonography seem to be correlated with risk of renal scarring, although the results were not statistically significant. C-reactive protein level is significantly correlated with renal scarring risk (p=0.047). Working outside the NICE guidelines allowed us to catch 7 further renal scars. Conclusions: It’s arguable if renal scintigraphy must be performed in all cases of pyelonephritis diagnosed in the first 24 months of life or only when there are other risk factors for renal scarring. Age, atypical urinary tract infection, C-reactive protein level and renal ultrasonography results must be taken into account in the decision to perform renal scintigraphy in a child. More prospective studies with larger cohorts are needed.
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spelling Urinary tract infections under 24 months old: Is it possible to predict the risk of renal scarring?Childrenal scarringrenal scintigraphyurinary tract infectionBackground: Urinary tract infection is one of the most common bacterial infections in the first two years of life and it can lead to irreversible renal scarring. Renal scintigraphy is the gold standard method for detection of renal scars. The aim of our work was to revise the cases of pyelonephritis, detect the possible predictors for renal scarring and compare those results we would have obtained if we had followed current NICE guidelines. Methods: Retrospective analysis of all patients aged under 24 months evaluated in the paediatric department and diagnosed with pyelonephritis during a three-year period. We excluded the cases in which no renal scintigraphy was performed. Results: Of the 59 children analysed, 50.8% were boys and 86.4% were under one-year old. Escherichia coli was the predominant bacteria. Renal ultrasonography showed abnormal findings in 23 patients (39%). The incidence of renal scarring was 15.3%. Age, atypical urinary tract infection and abnormal renal ultrasonography seem to be correlated with risk of renal scarring, although the results were not statistically significant. C-reactive protein level is significantly correlated with renal scarring risk (p=0.047). Working outside the NICE guidelines allowed us to catch 7 further renal scars. Conclusions: It’s arguable if renal scintigraphy must be performed in all cases of pyelonephritis diagnosed in the first 24 months of life or only when there are other risk factors for renal scarring. Age, atypical urinary tract infection, C-reactive protein level and renal ultrasonography results must be taken into account in the decision to perform renal scintigraphy in a child. More prospective studies with larger cohorts are needed.Sociedade Portuguesa de Nefrologia2017-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/reporttext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000200003Portuguese Journal of Nephrology & Hypertension v.31 n.2 2017reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692017000200003Miranda,Ana MGarcia,CatarinaBento,Vanda APinto,Sarainfo:eu-repo/semantics/openAccess2024-02-06T17:04:55Zoai:scielo:S0872-01692017000200003Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:18:58.318795Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Urinary tract infections under 24 months old: Is it possible to predict the risk of renal scarring?
title Urinary tract infections under 24 months old: Is it possible to predict the risk of renal scarring?
spellingShingle Urinary tract infections under 24 months old: Is it possible to predict the risk of renal scarring?
Miranda,Ana M
Child
renal scarring
renal scintigraphy
urinary tract infection
title_short Urinary tract infections under 24 months old: Is it possible to predict the risk of renal scarring?
title_full Urinary tract infections under 24 months old: Is it possible to predict the risk of renal scarring?
title_fullStr Urinary tract infections under 24 months old: Is it possible to predict the risk of renal scarring?
title_full_unstemmed Urinary tract infections under 24 months old: Is it possible to predict the risk of renal scarring?
title_sort Urinary tract infections under 24 months old: Is it possible to predict the risk of renal scarring?
author Miranda,Ana M
author_facet Miranda,Ana M
Garcia,Catarina
Bento,Vanda A
Pinto,Sara
author_role author
author2 Garcia,Catarina
Bento,Vanda A
Pinto,Sara
author2_role author
author
author
dc.contributor.author.fl_str_mv Miranda,Ana M
Garcia,Catarina
Bento,Vanda A
Pinto,Sara
dc.subject.por.fl_str_mv Child
renal scarring
renal scintigraphy
urinary tract infection
topic Child
renal scarring
renal scintigraphy
urinary tract infection
description Background: Urinary tract infection is one of the most common bacterial infections in the first two years of life and it can lead to irreversible renal scarring. Renal scintigraphy is the gold standard method for detection of renal scars. The aim of our work was to revise the cases of pyelonephritis, detect the possible predictors for renal scarring and compare those results we would have obtained if we had followed current NICE guidelines. Methods: Retrospective analysis of all patients aged under 24 months evaluated in the paediatric department and diagnosed with pyelonephritis during a three-year period. We excluded the cases in which no renal scintigraphy was performed. Results: Of the 59 children analysed, 50.8% were boys and 86.4% were under one-year old. Escherichia coli was the predominant bacteria. Renal ultrasonography showed abnormal findings in 23 patients (39%). The incidence of renal scarring was 15.3%. Age, atypical urinary tract infection and abnormal renal ultrasonography seem to be correlated with risk of renal scarring, although the results were not statistically significant. C-reactive protein level is significantly correlated with renal scarring risk (p=0.047). Working outside the NICE guidelines allowed us to catch 7 further renal scars. Conclusions: It’s arguable if renal scintigraphy must be performed in all cases of pyelonephritis diagnosed in the first 24 months of life or only when there are other risk factors for renal scarring. Age, atypical urinary tract infection, C-reactive protein level and renal ultrasonography results must be taken into account in the decision to perform renal scintigraphy in a child. More prospective studies with larger cohorts are needed.
publishDate 2017
dc.date.none.fl_str_mv 2017-06-01
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dc.publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
dc.source.none.fl_str_mv Portuguese Journal of Nephrology & Hypertension v.31 n.2 2017
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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