ArticlePediatric nephrology (Berlin, Germany)2010
Evaluating different imaging strategies in children after first febrile urinary tract infection.
Article in Pediatric nephrology (Berlin, Germany), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Dimercaptosuccinic acid scan or ultrasound in screening for vesicoureteral reflux among children with urinary tract infections.The Cochrane database of systematic reviews · 2016Pooled it
- Paediatric urinary tract infections: a retrospective application of the National Institute of Clinical Excellence guidelines to a large general practitioner referred historical cohort.Pediatric radiology · 2014Guideline
- Clinical predictors to guide additional evaluation after a first febrile urinary tract infection in children.World journal of urology · 2026Article
- Ultrasonography Results in First Urinary Tract Infection During Childhood: Which Age Group Should Be Screened?Indian journal of pediatrics · 2023Article
- Androgen exposure potentiates formation of intratubular communities and renal abscesses by Escherichia coli.Kidney international · 2018Article
- Renal scar formation and kidney function following antibiotic-treated murine pyelonephritis.Disease models & mechanisms · 2017Article
- Screening high-grade vesicoureteral reflux in young infants with a febrile urinary tract infection.Pediatric nephrology (Berlin, Germany) · 2012Article
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Authors and funding
11 authors at 8 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We conducted a retrospective multicenter review to estimate the prevalence of urological abnormalities in Chinese children with first febrile urinary tract infection (UTI) and to evaluate the selective imaging strategy recommended by the NICE guideline for detecting underlying abnormalities. Atypical UTI was defined as in the NICE UTI guideline. Overall, 576 boys and 244 girls aged below 24 months were reviewed. All underwent ultrasound (US) and micturating cystourethrogram (MCUG) and 612 underwent DMSA scans. US was abnormal in 73 (8.9%) and vesicoureteral reflux was shown in 195 patients (23.8%). A total of 126 patients were considered to have remediable urological abnormalities requiring additional surgical or medical interventions. The NICE guideline yielded excellent negative predictive values (NPV) of 100-94.4% in girls but 91% in boys. If all boys underwent US and DMSA and only those with atypical UTI or abnormal US or DMSA proceeded to MCUG, then the NPV increased to 95.2% and 97.4% for boys aged below and above 6 months, respectively. These revised strategies would substantially save invasive studies-DMSA and MCUG in 27 and 74% of girls aged below and above 6 months, respectively, or MCUG in 23 and 59% of boys aged below and above 6 months, respectively.
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