ArticlePediatric nephrology (Berlin, Germany)2012
Screening high-grade vesicoureteral reflux in young infants with a febrile urinary tract infection.
Article in Pediatric nephrology (Berlin, Germany), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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14 citing papers in PubMed, 2 syntheses or guidelines pooled it, 68 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
- Predictive value of normal renal ultrasound after first febrile UTI in infants under six months: a retrospective chart review.World journal of urology · 2026Article
- Can diagnostic and imaging recommendations from the 2011 AAP UTI guidelines be applied to infants <2 months of age?Journal of pediatric urology · 2022Article
- Comparison of Urinary Tract Dilatation and Society of Fetal Urology systems in the detection of vesicourethral reflux and renal scar.Polish journal of radiology · 2021Article
- Role of Late DMSA Renal Scan in Detecting High-Grade Vesicoureteral Reflux.Indian journal of pediatrics · 2019Article
- Predictive value of specific ultrasound findings when used as a screening test for abnormalities on VCUG.Journal of pediatric urology · 2015Article
- 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
- Practical approach to screen vesicoureteral reflux after a first urinary tract infection.Indian journal of urology : IJU : journal of the Urological Society of India · 2014Article
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- Urinary concentration of cytokines in children with acute pyelonephritis.European journal of pediatrics · 2013Observational
- Update on recent guidelines for the management of urinary tract infections in children: the shifting paradigm.Current opinion in pediatrics · 2013Review
- The combination of urinary IL - 6 and renal biometry as useful diagnostic tools to differentiate acute pyelonephritis from lower urinary tract infection.International braz j urol : official journal of the Brazilian Society of UrologyArticle
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe lack of good evidence for improved outcomes in children and young infants with febrile urinary tract infection (UTI) after aggressive treatment for vesicoureteral reflux (VUR) has raised doubts regarding the need for routine voiding cystourethrography (VCUG), and the appropriate imaging evaluation in these children remains controversial.
objectivesThis prospective study aimed to determine whether abnormalities found on acute dimercaptosuccinic acid (DMSA) scan and ultrasound (US) can help indicate the necessity of voiding cystourethrography (VCUG) in young infants.
methodsFor 3.5 years, all infants younger than 3 months presenting with first febrile UTI were prospectively studied. All infants were hospitalized and investigated using US (<3 days after admission), DMSA scan (<5 days after admission), and VCUG (7-10 days after antibiotic treatment) after diagnosis. The association among findings of US, DMSA scan, and VCUG were evaluated.
resultsFrom 220 infants, there were abnormal results in 136 (61.8%) US and in 111 (50.5%) DMSA scans. By US, ten infants (4.5%) with abscess or structural abnormalities other than VUR were diagnosed. High-grade (III-V) VUR was present in 39 patients (17.7%). The sensitivities for high-grade VUR of renal US alone (76.9%) or DMSA scan alone (82.1%) were not as good as that of the "OR rule" strategy, which had 92.3% sensitivity and 94.3% negative predictive value.
conclusionsTo screen high-grade VUR in young infants with febrile UTI, US and acute DMSA scan could be performed first. VCUG is only indicated when abnormalities are apparent on either US or DMSA scan or both.
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