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Risk factors in the development of early technetium‐99m dimercaptosuccinic acid renal scintigraphy lesions during first urinary tract infection in children
Author(s) -
FernándezMenéndez JM,
Málaga S,
Matesanz JL,
Solís G,
Alonso S,
PérezMéndez C
Publication year - 2003
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2003.tb00463.x
Subject(s) - medicine , dimercaptosuccinic acid , scintigraphy , urinary system , cystourethrography , reflux , logistic regression , technetium , gastroenterology , technetium 99m , etiology , nuclear medicine , vesicoureteral reflux , disease
Aim : To establish the variables that correlate with uptake defects in dimercaptosuccinic acid (DMSA) scintigraphy performed in the acute phase of a first episode of urinary tract infection (UTI). Methods : A prospective observational study was conducted in a cohort of 158 consecutive children with a first episode of symptomatic UTI. The therapeutic delay time (TDT) was recorded. DMSA scintigraphy was performed in all children and voiding cystourethrography in 150 of them. Results : 85% of the patients were younger than 2 y. Mean TDT was 33.5 h. The aetiological agent was Escherichia coli in 140 children. DMSA scintigraphy was normal in 81. Vesicoureteric reflux was detected in 33. After a multivariate logistic regression analysis the following variables were retained in the final model: TDT ≥48 h, growth of bacteria other than E. coli , percentage of polymorphonuclear cells ≥60% and C‐reactive protein ≥30 mg −1 . Conclusion : TDT ≥48 h, bacteria other than E. coli , percentage of polymorphonuclear cells ≥60% and CRP ≥30 mg −1 influence the findings detected in the DMSA scintigraphy performed in the acute phase of a first episode of UTI.