Acute pyelonephritis and renal scarring in Kuwaiti children: a follow-up study using 99mTc DMSA renal scintigraphy
- 23 June 2005
- journal article
- Published by Springer Science and Business Media LLC in Pediatric Nephrology
- Vol. 20 (8), 1116-1119
- https://doi.org/10.1007/s00467-005-1880-2
Abstract
The aim of this study was to determine the prevalence of renal scarring in a group of Kuwaiti Arab children with their first documented acute pyelonephritis (APN). Eighty-two Kuwaiti Arab children (10 males and 72 females) who had abnormal 99mTc DMSA renal scan findings of acute pyelonephritis were prospectively studied with the same imaging modality 6 months after treatment to identify those who developed renal scarring. A micturition cystourethrogram (MCUG) was performed for all of the children 1 month after diagnosis. Children were divided into 3 age groups (<2 years, 2–5 years and above 5 years). The follow-up DMSA renal scans 6 months after diagnosis revealed normalization of renal changes in 56% (46 patients), much improvement with residual renal abnormality in 6% (5 patients), and persistent parenchymal defects in 38% (31 patients). Vesicoureteric reflux (VUR) was found in 32% of children (26/82) and the majority were between grade I and III. Thirteen of those with VUR (50%) developed renal scars on follow-up. Fifty-three percent of the scarred kidneys (19/36) were drained by non-refluxing ureters. In this study, children older than 2 years had less VUR yet were more susceptible to APN and to the development of renal scars. Girls were more prone to developing APN and renal scarring than boys. This work shows that APN is a serious cause for renal scarring in our patients, particularly if associated with other risk factors such as recurrent infections and the female sex.Keywords
This publication has 28 references indexed in Scilit:
- Is ACE gene polymorphism a risk factor for renal scarring with low-grade reflux?Pediatric Nephrology, 2004
- Incidence of New Renal Parenchymal Inflammatory Changes Following Breakthrough Urinary Tract Infection in Patients With Vesicoureteral Reflux Treated With Antibiotic Prophylaxis: Evaluation by 99M Technetium Dimercapto-Succinic Acid Renal ScanJournal of Urology, 2003
- Acute renal damage in infants after first urinary tract infectionPediatric Nephrology, 2002
- Vesico‐ureteric reflux: occurrence and long‐term risksActa Paediatrica, 1999
- Vesico‐ureteric reflux and other risk factors for renal damage: identification of high‐ and low‐risk childrenActa Paediatrica, 1999
- The evaluation of acute pyelonephritis and renal scarring with technetium 99m-dimercaptosuccinic acid renal scintigraphy: evolving concepts and future directionsPediatric Nephrology, 1997
- Renal damage one year after first urinary tract infection: Role of dimercaptosuccinic acid scintigraphyThe Journal of Pediatrics, 1996
- Risk factors in the development of early renal cortical defects in children with urinary tract infection.American Journal of Roentgenology, 1994
- Renal scarring after acute pyelonephritis.Archives of Disease in Childhood, 1994
- Reflux nephropathy: Effects of antimicrobial therapy on the evolution of the early pyelonephritic scarKidney International, 1981