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Renal cortical involvement in children with first UTI: does it differ in the presence of primary VUR?

Gül Ege Aktaş1, Sabahat Inanir, Halil Turgut Turoğlu

  • 1Department of Nuclear Medicine, Medical Faculty, Marmara University, Altunizade, Istanbul, Turkey. glege2004@yahoo.com

Annals of Nuclear Medicine
|January 15, 2009
PubMed

Insights

Vesicoureteral reflux (VUR) significantly alters dimercaptosuccinic acid (DMSA) scan results in children experiencing their first urinary tract infection (UTI). Refluxing kidneys show more severe DMSA patterns, indicating potential kidney damage.

Area of Science:

  • Pediatric Nephrology
  • Nuclear Medicine
  • Urology

Background:

  • Urinary tract infections (UTIs) are common in children.
  • Vesicoureteral reflux (VUR) is a significant risk factor for renal scarring after UTI.
  • Dimercaptosuccinic acid (DMSA) scintigraphy is crucial for assessing renal damage in pediatric UTIs.

Purpose of the Study:

  • To evaluate how VUR influences DMSA scintigraphic findings in children with their initial symptomatic UTI.
  • To correlate VUR grades with specific DMSA patterns indicating renal cortical abnormalities.

Main Methods:

  • Retrospective analysis of 45 children (1 month-11 years) with first symptomatic UTI.
  • DMSA scans performed within 2 months of UTI diagnosis.
  • Analysis of 82 renal units, excluding those with bilateral cortical lesions, assessing differential renal function and cortical lesions.

Main Results:

  • Vesicoureteral reflux (VUR) was present in 32% of analyzed renal units.
  • Renal cortical abnormality was more frequent in units with VUR (50%) compared to those without (17%).
  • Decreased renal function (<45%) and cortical lesions were common in VUR cases, particularly with higher VUR grades (3-4).

Conclusions:

  • Vesicoureteral reflux (VUR) demonstrably impacts DMSA scintigraphy patterns in children with their first symptomatic UTI.
  • The presence and grade of VUR are associated with more severe DMSA findings, suggesting increased risk of renal damage.
Abstract

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