Childhood Kidney Diseases

  • 제24권1호
  • /
  • Pages.27-35
  • /
  • 2020
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  • 2384-0242(pISSN)
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  • 2384-0250(eISSN)
대한소아신장학회 (Korean Society of Pediatric Nephrology)
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Predictive Markers for Screening Renal Damage in Children with Urinary Tract infections and Vesicoureteral Reflux

  • Lee, Hyeonju (Department of Pediatrics, Jeju National University Hospital) ;
  • Choi, Jae Hong (Department of Pediatrics, Jeju National University Hospital) ;
  • Kang, Dong-Hyeok (Department of Medicine, Jeju National University School of Medicine) ;
  • Kim, Seunghyo (Department of Pediatrics, Jeju National University Hospital) ;
  • Kang, Ki-Soo (Department of Pediatrics, Jeju National University Hospital) ;
  • Han, Kyoung Hee (Department of Pediatrics, Jeju National University Hospital)
  • 투고 : 2020.02.14
  • 심사 : 2020.04.04
  • 발행 : 2020.04.30
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초록

Purpose: Urinary tract infections (UTIs) are the most common and serious bacterial infections in children. Therefore, early diagnosis of vesicoureteral reflux (VUR) for treatment planning and the identification of noninvasive markers that can predict renal injury are important in patients with UTIs. We analyzed the clinical features of pediatric UTIs commonly encountered by general practitioners and reinterpreted the blood tests and imaging findings to identify the important clinical predictive markers of VUR in order to selectively perform VCUG. Methods: This retrospective study was performed among 183 children diagnosed with a UTI or acute pyelonephritis. Results: The most significant predictor of high grade and bilateral VUR identified using area under the curve analyses was hydronephrosis on kidney ultrasound images with renal cortical defects on dimercaptosuccinic acid (DMSA) kidney scan simultaneously, followed by hydronephrosis only on kidney ultrasound. Conclusion: The presence of hydronephrosis on kidney ultrasound images or cortical defects or asymmetric kidneys on the DMSA kidney scans can be predictive markers of VUR, reducing the need for VCUG. Our study can thus help minimize the exposure to radiation among patients through selective VCUG.

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참고문헌

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