Pediatric Nephrology

, Volume 25, Issue 8, pp 1463–1469

Vesicoureteral reflux in children with suspected and proven urinary tract infection

  • Annukka Hannula
  • Mika Venhola
  • Marjo Renko
  • Tytti Pokka
  • Niilo-Pekka Huttunen
  • Matti Uhari
Original Article

DOI: 10.1007/s00467-010-1542-x

Cite this article as:
Hannula, A., Venhola, M., Renko, M. et al. Pediatr Nephrol (2010) 25: 1463. doi:10.1007/s00467-010-1542-x

Abstract

The aim of this study was to estimate the prevalence of vesicoureteral reflux (VUR) and clinically significant ultrasonography (US) abnormalities in a large group of children with proven and suspected urinary tract infection (UTI). The medical reports on renal US and voiding cystouretrographies (VCUG) of 2,036 children were reviewed. Renal US was performed on all children and VCUG on 1,185 children (58%). Based on the urine culture data, the UTI diagnoses were classified into five reliability classes (proven, likely, unlikely, false and no microbial data). The UTI diagnose was considered proven in 583/2036 (28.6%) and false in 145 (7.1%) cases. The prevalence of VUR was similar among those with proven and false UTI [37.4 vs. 34.8%; relative risk (RR) 1.08, 95% confidence intervals (95% CI) 0.7–1.7, P = 0.75] and decreased with increasing age (P = 0.001). Clinically significant US abnormalities occurred in 87/583 (14.9%) cases with proven UTI and significantly less often (11/145, 7.6%) in the false UTI class (RR 1.96, 95% CI 1.1–3.6, P = 0.02). Our finding supports the claim that VUR is not significantly associated to UTI and that its occurrence among children even without UTI is significantly higher than traditional estimates. This challenges the recommendations of routine VCUG after UTI.

Keywords

Renal ultrasonography Urinary tract abnormality Urinary tract infection Vesicoureteral reflux Voiding cystouretrography 

Copyright information

© IPNA 2010

Authors and Affiliations

  • Annukka Hannula
    • 1
  • Mika Venhola
    • 1
  • Marjo Renko
    • 1
  • Tytti Pokka
    • 1
  • Niilo-Pekka Huttunen
    • 1
  • Matti Uhari
    • 1
  1. 1.Department of PaediatricsUniversity of OuluOuluFinland

Personalised recommendations