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Published on: October 12, 2017
[Can vesicoureteral reflux be predicted in infants with urinary infection?]
M Sánchez Bayle1, G Yep Chullen, E de La Torre Montes de Neira
1Sección de Lactantes, Hospital Niño Jesús, Madrid. msanba@teleline.es
Insights
Predicting vesicoureteral reflux (VUR) in infants after their first urinary tract infection (UTI) is possible. Renal ultrasound anomalies and non-E. coli UTI significantly indicate VUR presence and severity.
Area of Science:
- Pediatric Nephrology
- Diagnostic Imaging
- Infectious Diseases
Context:
- Infantile urinary tract infections (UTIs) are common.
- Vesicoureteral reflux (VUR) is a significant risk factor for renal scarring.
- Accurate prediction of VUR in infants is crucial for timely intervention.
Purpose:
- To develop a predictive formula for VUR in infants experiencing their first UTI.
- To identify key indicators for VUR presence and severity.
Summary:
- A study of 267 infants with first UTIs analyzed renal ultrasound, VCUG, and CRP results.
- Multivariable analysis identified renal ultrasound anomalies and non-E. coli UTI as significant predictors of VUR.
- Oostenbruck's score was found to be ineffective for VUR detection.
Impact:
- Findings suggest limiting voiding cystourethrogram (VCUG) indications to infants with renal ultrasound anomalies or non-E. coli UTIs.
- This approach may optimize diagnostic workups for first-time UTIs in infants.
- Further research is needed to validate these predictive factors.
Aims:
To look forward for a formulae able to predict the presence of vesicoureteral reflux (VUR) in the first urinary tract infection (UTI) in infants.
Subjects And Methods:
We had studied all the diagnosticated first UTI in breast-fed babies in our hospital along 21/2 years. All had been subjects of a renal ultrasound scan, VCUG and CRP test. We have analyzed the result by diagnosis test and logistic regression.
Results:
We have studied 267 infants aged between 2 days and 24 months old.17,33% manifested UTI caused by germs different than E Coli, 40 subjects presented anomalies in the ultrasound scan and 108 manifested VUR. Oostenbruck s score had been useless in detecting VUR subjects. In the multivariable analysis the two variables of anomalies in the ultrasonographic scan and non E Coli caused UIT were the only ones to presented statistical significance to sign the presence of VUR and of the likeness of VUR of grade > or = 3. The negative probability coefficients for infants with ultrasonographics anomalies and/or UTI non E Coli produced were of 0,78 (IC 0,67-0,90) for all degrees of VUR, 0,25 (IC 0,10-0,52) for VUR with degree > or = 3 and 0 (IC 0-0,67) for VUR with degree > or = 4.
Conclusions:
We deduced that in children younger of 24 months old that suffer their first UTI the indication to proceeded with a VCUG could be limited to the subjects with present anomalies in the renal ultrasound scan and/or UTI non E Coli, thought there will precised more studies to confirm this findings.
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