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Renal power Doppler ultrasound does not predict renal scarring after urinary tract infection

H Narchi1, R Donovan

  • 1Paediatric Department, Sandwell General Hospital, West Bromwich, B71 4HJ, United Kingdom. hassibnarchi@hotmail.com

Scottish Medical Journal
|December 5, 2008
PubMed

Insights

Renal power Doppler (RPD) cannot reliably predict renal scarring after urinary tract infections (UTI) in young children. A late dimercapto-succinic acid (DMSA) scan remains necessary for accurate diagnosis of kidney damage.

Area of Science:

  • Pediatric Nephrology
  • Diagnostic Imaging
  • Infectious Diseases

Background:

  • Urinary tract infections (UTIs) in young children can lead to renal scarring, a condition difficult to diagnose early.
  • Permanent renal scars are typically identified months later using dimercapto-succinic acid (DMSA) scans.
  • Reducing radiation exposure from repeat scans is a clinical priority.

Purpose of the Study:

  • To evaluate the effectiveness of renal power Doppler (RPD) in predicting DMSA-diagnosed renal scarring after a first UTI in children under four.
  • To determine if RPD can identify children who may not need a follow-up DMSA scan, thereby reducing radiation exposure.

Main Methods:

  • Children under four with a first UTI had an early RPD scan.
  • A DMSA scintigraphy was performed six months later to assess for permanent renal scarring.
  • The predictive values of RPD for detecting DMSA-confirmed renal scarring were calculated.

Main Results:

  • Three out of 23 children (13%) developed permanent renal scarring.
  • RPD showed a sensitivity of 33.3% and a specificity of 97.7% for detecting renal scars.
  • The negative predictive value of RPD was 95.4%, but the positive predictive value was only 50%.

Conclusions:

  • Renal power Doppler (RPD) did not demonstrate an advantage over standard ultrasound in predicting renal scarring post-UTI.
  • RPD is not recommended as a tool to predict renal scarring in children following a urinary tract infection.
  • Further research may be needed to identify reliable early markers for renal scarring.
Abstract

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