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Comparative Study
. 2000 May;82(5):376-80.
doi: 10.1136/adc.82.5.376.

Risk assessment of renal cortical scarring with urinary tract infection by clinical features and ultrasonography

M T Christian  1 , J H McColl, J R MacKenzie, T J Beattie
Affiliations
Comparative Study

Risk assessment of renal cortical scarring with urinary tract infection by clinical features and ultrasonography

M T Christian et al. Arch Dis Child. 2000 May.

Abstract

Aims: To address some of the issues in the ongoing debate over the optimal diagnostic imaging following childhood urinary tract infection (UTI), by determining the risk of missing renal cortical scarring which would be detected on a technetium-99m dimercaptosuccinic acid (DMSA) gold standard if ultrasound alone were used, factoring for clinical features (upper or lower tract), UTI recurrence, and age group (infants, preschool, or school age).

Methods: Details of UTI clinical features and recurrence were recorded for 990 children with a proven UTI, and their DMSA and ultrasound results were compared for each kidney.

Results: The risks of missing DMSA scarring varied between 0.4% (school age children with solitary lower tract UTI) and 11.1% (infants with recurrent upper tract UTI).

Conclusions: UTI clinical features are important in assessing the need for DMSA imaging. Current UK imaging guidelines are endorsed, although preschool children with solitary lower tract UTI remain a controversial group and more attention needs to focused on children with recurrent UTI.

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Comment in

  • Are we requesting too many DMSA scans?
    Sackey AH. Sackey AH. Arch Dis Child. 2000 Nov;83(5):457. doi: 10.1136/adc.83.5.456e. Arch Dis Child. 2000. PMID: 11203154 Free PMC article. No abstract available.

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