ArticleArchives of disease in childhood2005
The presence of vesicoureteric reflux does not identify a population at risk for renal scarring following a first urinary tract infection.
Article in Archives of disease in childhood, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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29 citing papers in PubMed, 1 synthesis or guideline pooled it, 147 citations in OpenAlex.
- A guideline for the inpatient care of children with pyelonephritis.Annals of Saudi medicineGuideline
- Randomised trial of oral versus sequential intravenous/oral cephalosporins in children with pyelonephritis.European journal of pediatrics · 2008Trial
- Endoscopic injection therapy.Investigative and clinical urology · 2017Review
- Critical appraisal of the top-down approach for vesicoureteral reflux.Investigative and clinical urology · 2017Review
- Off-label-use of sulfur-hexafluoride in voiding urosonography for diagnosis of vesicoureteral reflux in children: A survey on adverse events.World journal of clinical pediatrics · 2017Article
- Imaging in childhood urinary tract infection.La Radiologia medica · 2016Review
- Insignificant impact of VUR on the progression of CKD in children with CAKUT.Pediatric nephrology (Berlin, Germany) · 2016Article
- Reappraisal of the effectiveness of ⁹⁹mTc-dimercaptosuccinic acid scans for selective voiding cystourethrography in children with a first febrile urinary tract infection.The Kaohsiung journal of medical sciences · 2014Article
- Comparison of procalcitonin and different guidelines for first febrile urinary tract infection in children by imaging.Pediatric nephrology (Berlin, Germany) · 2014Article
- History of recurrent urinary tract infection is not predictive of abnormality on voiding cystourethrogram.Pediatric surgery international · 2013Article
- NICE guidelines for imaging studies in children with UTI adequate only in boys under the age of 6 months.Pediatric surgery international · 2013Article
- Prediction of vesicoureteral reflux in children with first urinary tract infection by dimercaptosuccinic Acid and ultrasonography.Iranian journal of pediatrics · 2012Article
- Radiographic evaluation of children with febrile urinary tract infection: bottom-up, top-down, or none of the above?Advances in urology · 2012Article
- Economic and radiation costs of initial imaging approaches after a child's first febrile urinary tract infection.Clinical pediatrics · 2012Article
- Hepatic and pulmonary nodular lesions in pediatric urinary tract infections.Pediatric nephrology (Berlin, Germany) · 2011Article
- Predictors of abnormal renal cortical scintigraphy in children with first urinary tract infection: the importance of time factor.International urology and nephrology · 2010Article
- Catheter-free methods for vesicoureteric reflux detection: our experience and a critical appraisal of existing data.Pediatric nephrology (Berlin, Germany) · 2010Review
- Urinary tract infections in children: recommendations for antibiotic prophylaxis and evaluation. An evidence-based approach.Current urology reports · 2010Review
- Renal scintigraphy in children with vesicoureteral reflux.Indian journal of pediatrics · 2009Article
- Imaging studies for first urinary tract infection in infants less than 6 months old: can they be more selective?Pediatric nephrology (Berlin, Germany) · 2009Article
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Authors and funding
6 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundChildhood urinary tract infection (UTI) with or without vesicoureteric reflux (VUR) may predispose to renal scarring. There is no clear consensus in the literature regarding imaging following UTI in infancy.
aimsTo define the role of cystography following a first UTI in children aged under 1 year, when urinary tract ultrasonography (US) is normal.
methodsRetrospective data collection of 108 children (216 renal units) aged under 1 year at the time of a bacteriologically proven UTI. All had a normal US and underwent both catheter cystogram and DMSA test. Sensitivity, specificity, likelihood ratios positive and negative, and diagnostic odds ratio were calculated for VUR on cystography versus scarring on DMSA.
resultsVUR was shown in 25 (11.6%) renal units. Scarring on DMSA was seen in 8 (3.7 %) kidneys. Only 16% of kidneys with VUR had associated scarring; 50% of scarred kidneys were not associated with VUR. The likelihood ratio positive was 4.95 (95% CI 2.22 to 11.05) and the likelihood ratio negative was 0.56 (95% CI 0.28 to 1.11). The diagnostic odds ratio was 8.9, suggesting that cystography provided little additional information.
conclusionSince only 16% of children with VUR had an abnormal kidney, the presence of VUR does not identify a susceptible population with an abnormal kidney on DMSA. In the context of a normal ultrasound examination, cystography contributes little to the management of children under the age of 1 year with a UTI. In this context, a normal DMSA study reinforces the redundancy of cystography.
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