Dergiler / Turkish Journal of Urology / 2018 / Cilt: 44 - Sayı: 6

Delayed diagnosis of primary vesicoureteral reflux in children with recurrent urinary tract infections: Diagnostic approach and renal outcomes

Sayfa
498–502
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Awareness of childhood UTI in public and healthcare personnels should beincreased in order to refer these patients at a early stage to pediatric urology and nephrology units.

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Amaç & Hipotez:Objective: In this study, we aimed to assess renal outcomes of delayed diagnosis of dilating primary vesicoureteral reflux (VUR) following recurrent febrile urinary tract infections (fUTIs) and its diagnostic imagingprocedures.Material and methods: The medical records of patients who underwent ultrasonography (US), non- acutedimercaptosuccinic acid (Tc-99mDMSA) scintigraphy and voiding cystourethrography (VCUG), and whowere older than 2 years at the time of VUR diagnosis were retrospectively reviewed.Results: A total of 32 children (female, n=27: 84.4%) with a mean age of 7.67±3.34 years at the time ofdiagnosis of VUR were included in the study.
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Temel Bulgular & Veri:Grade III, IV, V VUR were found in 22%, 69%, and 9%of the patients, respectively.
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Sonuç & Katkı:Awareness of childhood UTI in public and healthcare personnels should beincreased in order to refer these patients at a early stage to pediatric urology and nephrology units.
🔬Tür:Literatür & Derleme Çalışması
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Özet

Objective: In this study, we aimed to assess renal outcomes of delayed diagnosis of dilating primary vesicoureteral reflux (VUR) following recurrent febrile urinary tract infections (fUTIs) and its diagnostic imagingprocedures.Material and methods: The medical records of patients who underwent ultrasonography (US), non- acutedimercaptosuccinic acid (Tc-99mDMSA) scintigraphy and voiding cystourethrography (VCUG), and whowere older than 2 years at the time of VUR diagnosis were retrospectively reviewed.Results: A total of 32 children (female, n=27: 84.4%) with a mean age of 7.67±3.34 years at the time ofdiagnosis of VUR were included in the study. Grade III, IV, V VUR were found in 22%, 69%, and 9%of the patients, respectively. At the time of VUR diagnosis, abnormal US findings were detected in 75%of the cases. Tc-99mDMSA detected abnormalities in 83.9% (7 with a single scar, 7 with multiple lesions,12 with reduced kidney function) of the patients. Estimated glomerular filtration rate of 3 patients withbilateral grade IV VUR was <75 mL/min/1.73 m2. In 5 patients (16%), VUR could not be predicted byUS+DMSA scintigraphy (Grade IV VUR in 3 and Grade III in 2 cases ). The sensitivity in predicting VURwas 75.00% (95% CI: 56.60-88.54) and 83.87% (95% CI: 66.27-94.55), respectively, for US alone and combined US+DMSA.Conclusion: VCUG should be performed routinely in addition to US and non-acute DMSA in all childrenreferred with recurrent fUTIs. Awareness of childhood UTI in public and healthcare personnels should beincreased in order to refer these patients at a early stage to pediatric urology and nephrology units.

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Bu Makaleye Atıf Yap

DOĞAN, Ç. S., KOYUN, N. S., AKSOY, G. K., ÇEKİÇ, B., SAVAŞ, M., ÇOMAK, E. (2018). Delayed diagnosis of primary vesicoureteral reflux in children with recurrent urinary tract infections: Diagnostic approach and renal outcomes. Turkish Journal of Urology, Cilt: 44 - Sayı: 6, 498–502. https://ajindex.com/articles/379882

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