Childhood Kidney Diseases

  • 제20권2호
  • /
  • Pages.57-62
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  • 2016
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  • 2384-0242(pISSN)
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  • 2384-0250(eISSN)
대한소아신장학회 (Korean Society of Pediatric Nephrology)
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Which Factors Related to the Renal Cortical Defects in Infants Under 3 Months of Age with Urinary Tract Infections?

  • An, Yu Kyung (Department of Pediatrics, Konkuk University Hospital) ;
  • Cho, Myung Hyun (Department of Pediatrics, Konkuk University Hospital) ;
  • Kim, Kyo Sun (Department of Pediatrics, Konkuk University Hospital)
  • 투고 : 2016.09.08
  • 심사 : 2016.10.16
  • 발행 : 2016.10.30
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초록

Purpose: We used technetium-99m dimercaptosuccinic acid (DMSA) scintigraphy to identify factors predictive of renal cortical defects in infants <3 months of age with urinary tract infections (UTIs). Methods: We retrospectively reviewed data on infants <3 months of age with culture-proven UTIs treated at a single center from March 2010 to February 2016. Blood samples were obtained for laboratory evaluation prior to commencement of antibiotic therapy. The therapeutic delay time (TDT) and therapeutic response time (TRT) were recorded. All patients were divided into two groups depending on features of their DMSA scans. We compared the demographic, clinical, and laboratory characteristics of the two groups. Results: A total of 119 infants (94 males and 25 females; mean age, $56.9{\pm}21.3days$) were included. Cortical defects were evident in the DMSA scans of 47 cases (39.5%). In infants with such defects, the peak temperatures ($38.9{\pm}0.57^{\circ}C$ vs. $38.4{\pm}0.81^{\circ}C$, P=0.001), the absolute neutrophil counts ($8,920{\pm}4,460/mm$ vs. $7,290{\pm}4,090/mm$, P=0.043), and the C-reactive protein (CRP) levels ($6.49{\pm}4.33mg/dL$ vs. $3.21{\pm}2.81mg/dL$, P=0.001) were significantly higher than those in infants without cortical defects. The TDT was also longer in those with cortical defects (P=0.037). Conclusion: We found that a TDT ${\geq}8.5hr$ (odds ratio [OR] 5.81), a peak temperature ${\geq}38.3^{\circ}C$ (OR 6.19), and a CRP level ${\geq}4.96mg/dL$ (OR 7.26) predicted abnormal DMSA scan results in infants <3 months of age with UTIs.

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참고문헌

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피인용 문헌

  1. Clinical Characteristics of Febrile UTI First Developed Over 5 Years of Age vol.21, pp.1, 2016, https://doi.org/10.3339/jkspn.2017.21.1.15
  2. Clinical implications of DMSA Scan in Childhood Acute Pyelonephritis vol.21, pp.2, 2016, https://doi.org/10.3339/jkspn.2017.21.2.107
  3. Clinical Characteristics and Outcomes of the First Episode of Urinary Tract Infection in Neonates and Infants Younger than 2 Months of Age vol.21, pp.2, 2016, https://doi.org/10.3339/jkspn.2017.21.2.94
  4. Prevalence and predictors of urinary tract infection in full-term and preterm neonates vol.68, pp.68, 2016, https://doi.org/10.1186/s43054-020-00022-2