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Yield of imaging performed as per Indian Society of Pediatric Nephrology guidelines in children with urinary tract infection

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Abstract

Objectives

To assess yield of imaging performed as per Indian Society of Pediatric Nephrology (ISPN) urinary tract infection (UTI) guideline.

Methods

Ultrasonography (USG), voiding cystourethrography (VCUG) and dimercaptosuccinic-acid (DMSA) scintigraphy were performed in 183 children (age 0–5y) with first episode (age 0–1y) of UTI or recurrent (age <5y) UTI, as per ISPN recommendations.

Results

Significant abnormalities were detected in 110 (63%), with vesicoureteric reflux (VUR) grades 3–5 in 31% and renal scars in 43%. Combined USG and DMSA had a negative predictive value of 94% for significant VUR.

Conclusion

ISPN guideline resulted in a high yield of detection of significant abnormalities.

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References

  1. Indian Society of Pediatric Nephrology; Vijayakumar M, Kanitkar M, Nammalwar BR, Bagga A. Revised statement on management of urinary tract infections. Indian Pediatr. 2011;48:709–17.

    Google Scholar 

  2. National Institute for Health and Clinical Excellence. Urinary Tract Infection in Children: Diagnosis, Treatment and Long Term Management. 2007. Clinical Guidelines, No. 54.

  3. Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011;128:595–610.

    Article  Google Scholar 

  4. Ammenti A1, Cataldi L, Chimenz R, Fanos V, La Manna A, Marra G, et al. Febrile urinary tract infections in young children: Recommendations for the diagnosis, treatment and follow-up. Acta Paediatr. 2012;101:451–7.

    Article  PubMed  Google Scholar 

  5. South M. Radiological investigations following urinary tract infection: changes in Australian practice. Arch Dis Child. 2009;94:927–30.

    Article  CAS  PubMed  Google Scholar 

  6. Tullus K. Outcome of post-infectious renal scarring. Pediatr Nephrol. 2015;30:1375–7.

    Article  PubMed  Google Scholar 

  7. McDonald K, Kenney I. Paediatric urinary tract infections: A retrospective application of the National Institute of Clinical Excellence guidelines to a large general practitioner referred historical cohort. Pediatr Radiol. 2014;44:1085–92.

    Article  PubMed  Google Scholar 

  8. Tse NK, Yuen SL, Chiu MC, Lai WM, Tong PC. Imaging studies for first urinary tract infection in infants less than 6 months old: can they be more selective? Pediatr Nephrol. 2009;24:1699–703.

    Article  PubMed  Google Scholar 

  9. Leonardo CR, Filgueiras MF, Vasconcelos MM, Vasconcelos R, Marino VP, Pires C, et al. Risk factors for renal scarring in children and adolescents with lower urinary tract dysfunction. Pediatr Nephrol. 2007;22: 1891–6.

    Article  PubMed  Google Scholar 

  10. Ajdinoviæ B, Jaukoviæ L, Krstiæ Z, Dopuda M. Technetium-99m-dimercaptosuccinic acid renal scintigraphy in children with urinary tract infections. Hell J Nucl Med. 2006;9:27–30.

    Google Scholar 

  11. Nammalwar BR, Vijayakumar M, Sankar J, Ramnath B, Prahlad N. Evaluation of the use of DMSA in culture positive UTI and culture negative acute pyelonephritis. Indian Pediatr. 2005;42:691–6.

    CAS  PubMed  Google Scholar 

  12. Hansson S, Dhamey M, Sigström O, Sixt R, Stokland E, Wennerström M, et al. Dimercapto-succinic acid scintigraphy instead of voiding cystourethrography for infants with urinary tract infection. J Urol. 2004;172: 1071–3.

    Article  PubMed  Google Scholar 

  13. Tseng NH, Lin WJ, Lo WT, Wang SR, Chu ML, Wang CC. Does a normal DMSA obviate the performance of voiding cystoureterography in evaluation of young children after their first urinary tract infection? J Pediatr. 2007;150:96–9.

    Article  PubMed  Google Scholar 

  14. Preda I, Jodal U, Sixt R, Stokland E, Hansson S. Normal dimercaptosuccinic acid scintigraphy makes voiding cystourethrography unnecessary after urinary tract infection. J Pediatr. 2007;151:581–4.

    Article  PubMed  Google Scholar 

  15. Lee HY, Soh BH, Hong CH, Kim MJ, Han SW. The efficacy of ultrasound and dimercaptosuccinic acid scan in predicting vesicoureteral reflux in children below the age of 2 years with their first febrile urinary tract infection. Pediatr Nephrol. 2009;24:2009–13.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Institute of Child Health, Kolkata, India

    Rajiv Sinha, Devdeep Mukherjee, Jayati Sengupta & Sushmita Banerjee

  2. Department of Pediatric Nephrology, AMRI Hospitals, Kolkata, India

    Rajiv Sinha, Jayati Sengupta & Subhasis Saha

  3. Department of Pediatric Nephrology, Calcutta Medical Research Institute, Kolkata, India

    Subhasis Saha & Sushmita Banerjee

Authors
  1. Rajiv Sinha
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  2. Devdeep Mukherjee
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  3. Jayati Sengupta
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  4. Subhasis Saha
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  5. Sushmita Banerjee
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Corresponding author

Correspondence to Sushmita Banerjee.

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Sinha, R., Mukherjee, D., Sengupta, J. et al. Yield of imaging performed as per Indian Society of Pediatric Nephrology guidelines in children with urinary tract infection. Indian Pediatr 54, 749–751 (2017). https://doi.org/10.1007/s13312-017-1168-1

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  • DOI: https://doi.org/10.1007/s13312-017-1168-1

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