Shaikh, N and Ewing, AL and Bhatnagar, S and Hoberman, A
(2010)
Risk of renal scarring in children with a first urinary tract infection: A systematic review.
Pediatrics, 126 (6).
1084 - 1091.
ISSN 0031-4005
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Abstract
BACKGROUND: To our knowledge, the risk of renal scarring in children with a urinary tract infection (UTI) has not been systematically studied. OBJECTIVE: To review the prevalence of acute and chronic renal imaging abnormalities in children after an initial UTI. METHODS: We searched Medline and Embase for English-, French-, and Spanish-language articles using the following terms: "Technetium 99mTc dimercaptosuccinic acid (DMSA)," "DMSA," "dimercaptosuccinic," "scintigra*," "pyelonephritis," and "urinary tract infection." We included articles if they reported data on the prevalence of abnormalities on acute-phase (≤15 days) or follow-up (>5 months) DMSA renal scans in children aged 0 to 18 years after an initial UTI. Two evaluators independently reviewed data from each article. RESULTS: Of 1533 articles found by the search strategy, 325 full-text articles were reviewed; 33 studies met all inclusion criteria. Among children with an initial episode of UTI, 57% (95% confidence interval [CI]: 50-64) had changes consistent with acute pyelonephritis on the acute-phase DMSA renal scan and 15% (95% CI: 11-18) had evidence of renal scarring on the follow-up DMSA scan. Children with vesicoureteral reflux (VUR) were significantly more likely to develop pyelonephritis (relative risk [RR]: 1.5 [95% CI: 1.1-1.9]) and renal scarring (RR: 2.6 [95% CI: 1.7-3.9]) compared with children with no VUR. Children with VUR grades III or higher were more likely to develop scarring than children with lower grades of VUR (RR: 2.1 [95% CI: 1.4-3.2]). CONCLUSIONS: The pooled prevalence values provided from this study provide a basis for an evidence-based approach to the management of children with this frequently occurring condition. Copyright © 2010 by the American Academy of Pediatrics.
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Details
Item Type: |
Article
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Status: |
Published |
Creators/Authors: |
Creators | Email | Pitt Username | ORCID  |
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Shaikh, N | nas67@pitt.edu | NAS67 | | Ewing, AL | | | | Bhatnagar, S | | | | Hoberman, A | | | |
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Date: |
1 December 2010 |
Date Type: |
Publication |
Journal or Publication Title: |
Pediatrics |
Volume: |
126 |
Number: |
6 |
Page Range: |
1084 - 1091 |
DOI or Unique Handle: |
10.1542/peds.2010-0685 |
Schools and Programs: |
School of Medicine > Pediatrics |
Refereed: |
Yes |
ISSN: |
0031-4005 |
Related URLs: |
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Article Type: |
Review |
MeSH Headings: |
Child; Cicatrix--etiology; Cicatrix--pathology; Humans; Kidney--pathology; Kidney Diseases--etiology; Kidney Diseases--pathology; Risk Factors; Urinary Tract Infections--complications |
PubMed ID: |
21059720 |
Date Deposited: |
11 Sep 2012 21:45 |
Last Modified: |
23 Jun 2018 23:55 |
URI: |
http://d-scholarship.pitt.edu/id/eprint/14042 |
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