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Journal of the Korean Society of Pediatric Nephrology 2008;12(2): 178-185. doi: https://doi.org/10.3339/jkspn.2008.12.2.178
3개월 미만 요로감염 영아에서 중증 방광 요관 역류의 예측인자
이대용, 김나연, 조희연, 김지은, 심소연, 손동우, 전인상, 차한
1가천의과학대학교 소아청소년과학교실
2가천의과학대학교 소아청소년과학교실
3가천의과학대학교 소아청소년과학교실
4가천의과학대학교 영상의학과교실
5가천의과학대학교 소아청소년과학교실
6가천의과학대학교 소아청소년과학교실
7가천의과학대학교 소아청소년과학교실
8가천의과학대학교 소아청소년과학교실
Prediction of High Grade Vesicoureteral Reflux in Infants Less than 3 Months with Urinary Tract Infection
Dae-Yong Yi, Na-Yeon Kim, Hee-Yeon Cho, Ji-Eun Kim, So-Yeon Sim, Dong-Woo Son, In-Sang Jeon, Han Cha
1Department of Pediatrics, Gachon University of Medicine and Science
2Department of Pediatrics, Gachon University of Medicine and Science
3Department of Pediatrics, Gachon University of Medicine and Science
4Department of Radiology, Gachon University of Medicine and Science
5Department of Pediatrics, Gachon University of Medicine and Science
6Department of Pediatrics, Gachon University of Medicine and Science
7Department of Pediatrics, Gachon University of Medicine and Science
8Department of Pediatrics, Gachon University of Medicine and Science
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ABSTRACT
Purpose : Our aim was to investigate the predictive factors for detecting grade III-V vesicoureteral reflux(VUR) in young infants less than 3 months with urinary tract infections (UTI).
Methods : Data of infants who underwent ultrasonography and VCUG between January 2004 and September 2007 were reviewed. Age, gender, incidence of bacteremia, C-reactive protein(CRP) and imaging studies were compared between group I(grade III-V VUR) and group II (normal or grade I and II VUR) retrospectively. Sensitivity, specificity, positive and negative predictive values, odds ratio, and likelihood ratio of ultrasonography for high grade VUR were evaluated.
Results : Among 54 enrolled infants(41 males, 13 females), 14 infants were group I and 40 infants were group II. In the group I, CRP level was significantly higher(6.11$pm$5.18 vs. 3.27$pm$3.45, P=0.025), and there were more ultrasonographic abnormal findings(71.4%, vs. 22.5%, P=0.002) compared with group II. However, ultrasonography was the only significant factor after adjusting with logistic regression(P=0.002). Incidence of bacteremia and abnormal DMSA findings were not significantly different in two groups. Sensitivity, specificity, and odds ratio of ultrasonography was 71.4%, 77.5%, 6.9 respectively. Negative predictive value was 88.6% and negative likelihood ratio was 0.37. Ultrasonography had significant negative likelihood ratio for grade III-V VUR, but missed 4 infants with grade III VUR.
Conclusion : We could not find any alternative predictive factors to reduce VCUG in detecting high grade VUR. Therefore, VCUG must be considered in young infants less than 3 months with UTI.
Key words: Urinary tract infection | Vesicoureteral reflux | Ultrasonography
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