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Childhood Kidney Diseases 2017;0(0): 0
Prognostic Factors of Renal Scarring on the follow-up DMSA Scan in Children with Acute Pyelonephritis
Received: September 23, 2016;  Accepted: October 19, 2016.
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Purpose: It has been emphasized that early diagnosis and treatment of urinary tract infection prevent renal scarring. If untreated, acute pyelonephritis could cause renal injury which leads to renal scarring, hypertension, proteinuria, and chronic renal failure. The purpose of this study is to assess risk factors of renal scarring after being treated with acute pyelonephritis.
Methods: The medical records of 59 patients admitted to Daegu Fatima Hospital for acute pyelonephritis(APN) from March 2008 to April 2015 were reviewed retrospectively whose renal cortical defects were confirmed by DMSA scan. We divided 59 patients into 2 groups according to the presence of renal scar and assessed the risk factors of renal scar as sex, age at diagnosis, feeding method, hydronephrosis, species of bacteria, vesicoureteral reflux and its grade.
Results : 24 patients out of 59 (40.7%) showed renal scar on followed-up DMSA scan. There were no signigicant difference in sex, hydronephrosis, species of bacteria and duration of fever between renal-scarred group and non-scarred group. As for age at diagnosis, age over 12 months had 5.8 times higher incidence rate of renal scarring. Vesicoureteral reflux(VUR) has affected on renal scar formation. VUR grade III-IV group had 14.7 times greater influence on renal scar formation compared to VUR grade I-II group.
Conclusion : Our data suggest that the presence of VUR and its grade and age at diagnosis are risk factors for renal scar on follow-up DMSA scan after acute pyelonephritis.
Key words: Acute pyelonephritis; Renal scar; Vesicoureteral reflux
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