|
KMID : 0811820100140020195
|
|
Journal of Korean Society of Pediatric Nephrology
2010 Volume.14 No. 2 p.195 ~ p.202
|
|
|
Prognostic Factors of Renal Defects on the Initial DMSA Scan in Children with Acute Pyelonephritis
|
|
Seo Yeong-Seon
Kwon Duck-Geun
Shin Yun-Hye
Pai Ki-Soo
|
|
|
Abstract
|
|
|
Purpose:The purpose of this study is to determine if there are prognostic factors leading to permanent parenchymal damages to kidney in children after acute pyelonephritis.
Methods:This study was conducted in 160 pediatric patients with acute pyelonephritis admitted to Ajou University Hospital from 2000 to 2005, whose renal cortical defects were confirmed by 99mTc-dimercaptosuccinic acid scintigraphy (DMSA scan). Along with the follow-up DMSA scan after 6 months, they were classified into two groups; recovered group (106) and scarred group (54). The clinical characteristics of each group were compared.
Results:Among the total of 160 patients, 106 (66.3%) showed recovery of the initial defect (the recovered group), while 54 (33.8%) showed permanent defects on the follow- up DMSA scan (scarred group). Recovery rate was poor for patients of 1 year and older, or patients with the duration of fever and pyuria longer than 7 days. The recovery rate was poor in the patients with history of frequent febrile episodes and abnormal results of imaging studies, such as voiding cystourethrography (VCUG), ultrasonography.
Conclusion:The recovery rate of children with renal defects on DMSA scan with acute pyelonephritis was lower when the patient is older than 1 year, when the duration of fever and pyuria exceeded 7 days, and when the patients had the histories of frequent febrile episodes and had urinary tract abnormalities on imaging studies. These findings suggest that there may be under- or mis-diagnosis of acute pyelonephritis by pediatrician.
|
|
|
KEYWORD
|
|
|
Acute pyelonephritis, Urinary tract infection, 99mTc-DMSA scintigraphy, Recovery of renal defect, Frequent febrile episode
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
  
|