Are Clinical, Laboratory, and Imaging Markers Suitable Predictors of Vesicoureteral Reflux in Children With Their First Febrile Urinary Tract Infection?
Mahyar Abolfazl, Ayazi Parviz, Mavadati Shiva, Habibi Morteza, Oveisi Sonia, Esmaeily Shiva,
소속 상세정보
( Mahyar Abolfazl )
Qazvin University of Medical Sciences Qazvin Children Hospital Department of Pediatrics
( Ayazi Parviz )
Qazvin University of Medical Sciences Qazvin Children Hospital Department of Pediatrics
( Mavadati Shiva )
Qazvin University of Medical Sciences Qazvin Children Hospital Department of Pediatrics
( Habibi Morteza )
Qazvin University of Medical Sciences Qazvin Children Hospital Department of Pediatrics
( Oveisi Sonia )
Qazvin University of Medical Sciences Metabolic Diseases Research Center Maternity and Child Health
( Esmaeily Shiva )
Qazvin University of Medical Sciences Department of Statistics
KMID : 0358320140550080536
Abstract
Purpose: This study was conducted to determine the predictive value of clinical, laboratory, and imaging variables for the diagnosis of vesicoureteral reflux in children with their first febrile urinary tract infection.
Materials and Methods: One hundred fifty-three children with their first febrile urinary tract infection were divided into two groups according to the results of voiding cystourethrography: 60 children with vesicoureteral reflux and 93 children without. The sensitivity, specificity, positive and negative predictive value, likelihood ratio (positive and negative), and accuracy of the clinical, laboratory, and imaging variables for the diagnosis of vesicoureteral reflux were determined.
Results: Of the 153 children with febrile urinary tract infection, 60 patients (39.2%) had vesicoureteral reflux. There were significant differences between the two groups regarding fever>38℃, suprapubic pain, C-reactive protein quantitative level, number of red blood cells in the urine, and results of renal ultrasound and dimercaptosuccinic acid renal scanning (p<0.05). There were significant positive correlations between fever>38.2℃ and dimercaptosuccinic acid renal scanning and vesicoureteral reflux. Also, there were significant positive correlations between the erythrocyte sedimentation rate, positive urinary nitrite test, hyaline cast, and renal ultrasound and high-grade vesicoureteral reflux.
Conclusions: This study revealed fever>38.2℃ and dimercaptosuccinic acid renal scanning as the best predictive markers for vesicoureteral reflux in children with their first febrile urinary tract infection. In addition, erythrocyte sedimentation rate, positive urinary nitrite test, hyaline cast, and renal ultrasound are the best predictive markers for high-grade vesicoureteral reflux.
키워드
99mTc-Dimercaptosuccinic acid scan;Sedimentation rate;Urinary tract infections;Vesicoureteral reflux
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