Related Experiment Videos
[Laboratory parameters as a guide for the radiologic study of infections of the urinary tract in childhood]
Insights
Urinary tract malformations in children with infections are common. Combining Erythrocyte Sedimentation Rate (ESR) and concentration ability tests best predicts the need for urinary tract X-rays.
Area of Science:
- Pediatrics
- Nephrology
- Medical Diagnostics
Background:
- Urinary tract infections (UTIs) are prevalent in children.
- A significant percentage of pediatric UTIs are associated with underlying urinary tract malformations.
- Identifying children requiring further investigation, such as urinary tract X-rays, is crucial for timely intervention.
Purpose of the Study:
- To evaluate the diagnostic utility of various clinical and laboratory parameters in predicting urinary tract malformations in children with UTIs.
- To determine the most effective combination of tests for identifying patients who need radiographic evaluation.
Main Methods:
- Studied 49 children (15 days to 10 years) diagnosed with UTIs.
- Assessed White Blood Cells, leukocyte differential, Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), urine concentration ability, and body temperature.
- Analyzed the sensitivity and specificity of individual tests and combinations for predicting malformations.
Main Results:
- Urinary tract malformations were present in 67.3% of the studied children.
- Individual parameters showed limited sensitivity; ESR and CRP demonstrated the highest correlation with malformations (76%).
- Combining ESR and urine concentration ability yielded the highest sensitivity (97%) and specificity (31%) for predicting malformations.
Conclusions:
- No single tested parameter reliably predicts urinary tract malformations in children with UTIs.
- The combination of ESR and urine concentration ability offers a highly sensitive, though less specific, approach to identify children needing further imaging.
- This combined approach can aid in selecting pediatric UTI patients for X-ray studies.
Abstract:
Forty-nine children with urinary tract infection aged between 15 days and 10 years were studied. Thirty-three of them (67.3%) had urinary tract malformations. We valued the following parameters: a) White Blood Cells; b) Leukocyte differential; c) ESR at the first hour; d) CRP; e) Concentration ability; f) Body temperature. We wanted to investigate the usefulness of these parameters to predict which patients should be studied by X-ray of urinary tract. Single parameters did not prove very sensitive; the highest correlations were found with ESR and CRP, which were positive in 76% of the cases of malformations. Furthermore we valued the sensitivity and specificity of the tests grouped together: the highest values of sensitivity (97%) and specificity (31%) were obtained coupling the ESR and concentration ability.