ArticleThe Journal of urology2013
Incidence of abnormal imaging and recurrent pyelonephritis after first febrile urinary tract infection in children 2 to 24 months old.
Article in The Journal of urology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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18 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 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
- Targeted Workup after Initial Febrile Urinary Tract Infection: Using a Novel Machine Learning Model to Identify Children Most Likely to Benefit from Voiding Cystourethrogram.The Journal of urology · 2019Trial
- Conflicting views of physicians and surgeons concerning pediatric urinary tract infection: a comparative review.Pediatric radiology · 2023Review
- The Role of Urinary NGAL in the Management of Primary Vesicoureteral Reflux in Children.International journal of molecular sciences · 2023Review
- Contemporary Management of Urinary Tract Infections in Children.Current treatment options in pediatrics · 2022Review
- Clinical manifestations, laboratory markers, and renal ultrasonographic examinations in 1-month to 12-year-old Iranian children with pyelonephritis: a six-year cross-sectional retrospective study.BMC infectious diseases · 2021Article
- Targeted Indication of Imaging for Detection of Vesicoureteric Reflux after Pediatric Febrile Urinary Tract Infections Based on a Multiparametric Computational Tool.Indian journal of pediatrics · 2020Article
- Urinary tract infections in children < 2 years of age hospitalized in a tertiary medical center in Southern Israel: epidemiologic, imaging, and microbiologic characteristics of first episode in life.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2020Article
- The prevalence of vesicoureteral reflux in infants with first urinary tract infection following circumcision is similar to infants with UTI not following circumcision.International urology and nephrology · 2020Article
- Evaluation of abnormal radiological findings in children aged 2 to 36 months followed by recurrent urinary tract infection: a retrospective study.Renal failure · 2017Article
- Critical appraisal of the top-down approach for vesicoureteral reflux.Investigative and clinical urology · 2017Review
- Neutrophil gelatinase-associated lipocalin: utility in urologic conditions.Pediatric nephrology (Berlin, Germany) · 2017Article
- A novel approach to evaluating the benefit of post-urinary tract infection renal ultrasonography, using decision curve analysis.Pediatric nephrology (Berlin, Germany) · 2016Article
- Controversies in the Management of Vesicoureteral Reflux.Current urology reports · 2015Review
- Radiologic and clinical evaluation of children with first febrile urinary tract infection.International journal of pediatrics & adolescent medicine · 2015Article
- Epidemiology and characteristics of urinary tract infections in children and adolescents.Frontiers in cellular and infection microbiology · 2015Article
- Article
- The role of voiding cystourethrography in the investigation of children with urinary tract infections.Canadian Urological Association journal = Journal de l'Association des urologues du CanadaReview
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8 authors at 1 institution in 1 country.
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Abstract
purposeThe AAP (American Academy of Pediatrics) no longer recommends voiding cystourethrogram in children 2 to 24 months old who present with a first urinary tract infection if renal-bladder ultrasound is normal. We identified factors associated with abnormal imaging and recurrent pyelonephritis in this population. MATERIALS AND
methodsWe retrospectively evaluated children diagnosed with a first episode of pyelonephritis at age 2 to 24 months using de-identified electronic medical record data from an institutional database. Data included age at first urinary tract infection, gender, race/ethnicity, need for hospitalization, intravenous antibiotic use, history of abnormal prenatal ultrasound, renal-bladder ultrasound and voiding cystourethrogram results, urinary tract infection recurrence and surgical intervention. Risk factors for abnormal imaging and urinary tract infection recurrence were analyzed by univariate logistic regression, the chi-square test and survival analysis.
resultsWe identified 174 patients. Of the 154 renal-bladder ultrasounds performed 59 (38%) were abnormal. Abnormal prenatal ultrasound (p = 0.01) and the need for hospitalization (p = 0.02) predicted abnormal renal-bladder ultrasound. Of the 95 patients with normal renal-bladder ultrasound 84 underwent voiding cystourethrogram. Vesicoureteral reflux was more likely in patients who were white (p = 0.003), female (p = 0.02) and older (p = 0.04). Despite normal renal-bladder ultrasound, 23 of 84 patients (24%) had dilating vesicoureteral reflux. Of the 95 patients with normal renal-bladder ultrasound 14 (15%) had recurrent pyelonephritis and 7 (7%) went on to surgical intervention.
conclusionsDespite normal renal-bladder ultrasound after a first pyelonephritis episode, a child may still have vesicoureteral reflux, recurrent pyelonephritis and the need for surgical intervention. If voiding cystourethrogram is deferred, parents should be counseled on these risks.
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