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• W2297805616 abstract "The aims were to evaluate the occurrence of vesicoureteral reflux (VUR) in children, to assess the frequency of significant ultrasonography (US) abnormalities and to study whether abandoning the use of voiding cystourethrographies (VCUG) is safe in children with urinary tract infection (UTI). We analysed reports on US and VCUG in a consecutive series of 406 paediatric patients and in a large population-based group of 2036 children with UTI. Based on the urine culture data, we analysed the frequencies of VUR and US abnormalities in relation to the reliability of the UTI diagnoses. Using a cohort of 1185 children on whom both VCUG and US had been performed, we evaluated whether US imaging alone is sufficient. In a follow-up study, we excluded 24 cases with major renal dysplasia or obstruction of the urinary tract from this cohort of 1185 children leaving a series of 1161 cases, of which 228 were randomly selected for follow-up and 193 (85%) participated, with a mean follow-up time of 11 years (range 6 to 17 years). The occurrence of VUR was similar among the children with proven (37%) or certain (36%) versus false (35%) or improbable (36%) UTI and decreased with increasing age. Significant US abnormalities were found in 10% and the frequency increased as the diagnostic reliability improved (15% in the proven UTI class and 8% in the false class). In the cohort of 1185 children, initial US was normal in 861 (73%), out of whom VCUG identified two cases of urethral valves and 40 cases of grade III to V VUR who could have benefited from surgical treatment, giving a figure of 42/861 (5%) for pathological findings that might have been missed if VCUG had not been performed. In the follow-up study, unilateral renal parenchymal defect was found in 22 (15%) out of the 150 patients who underwent control US, all except one of these being in patients with grade III to V VUR. Serum cystatin C concentration, estimated glomerular filtration rates and blood pressure were within the normal ranges in all the patients despite the defects seen in US. We conclude that VUR is a common age-related phenomenon in children and is not as closely associated with UTI as was previously thought. Children with UTI could be examined using US alone. Once obstructive uropathy and major renal dysplasia have been ruled out, the risk of longterm consequences in a case of childhood UTI is very low." @default.
• W2297805616 created "2016-06-24" @default.
• W2297805616 creator A5023119837 @default.
• W2297805616 date "2012-01-01" @default.
• W2297805616 modified "2023-09-23" @default.
• W2297805616 title "Imaging studies of the urinary tract in children with acute urinary tract infection" @default.
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