Fever Duration and Renal Scar in Pediatric Urinary Tract Infection

Jung, Ji-In; Lim, Dong-Hee; Yim, Hyung-Eun; Park, Man-Sik; Yoo, Kee-Hwan; Hong, Young-Sook; Lee, Joo-Won

doi:2008.12.1.70

J Korean Soc Pediatr Nephrol > Volume 12(1); 2008 > Article

J Korean Soc Pediatr Nephrol 2008;12(1): 70-77. doi: https://doi.org/10.3339/jkspn.2008.12.1.70

소아 요로감염에서 발열과 신반흔의 관계

정지인, 임동희, 임형은, 박만식, 유기환, 홍영숙, 이주원

¹고려대학교 의과대학 소아과학교실
²고려대학교 의과대학 소아과학교실
³고려대학교 의과대학 소아과학교실
⁴고려대학교 의과대학 의학통계학교실
⁵고려대학교 의과대학 소아과학교실
⁶고려대학교 의과대학 소아과학교실
⁷고려대학교 의과대학 소아과학교실

Fever Duration and Renal Scar in Pediatric Urinary Tract Infection

Ji-In Jung, Dong-Hee Lim, Hyung-Eun Yim, Man-Sik Park, Kee-Hwan Yoo, Young-Sook Hong, Joo-Won Lee

¹Department of Pediatrics, College of Medicine, Korea University
²Department of Pediatrics, College of Medicine, Korea University
³Department of Pediatrics, College of Medicine, Korea University
⁴Department of Biostatistics, College of Medicine, Korea University
⁵Department of Pediatrics, College of Medicine, Korea University
⁶Department of Pediatrics, College of Medicine, Korea University
⁷Department of Pediatrics, College of Medicine, Korea University

ABSTRACT

PURPOSE: Urinary tract infections(UTIs) are not uncommon findings in febrile pediatric patients and approximately one third of patients with UTI may have renal scars. This research was intended to establish the relationship between duration of fever and renal scars. METHODS: The medical records of 143 patients were reviewed retrospectively. Inclusion criteria were as follows: 1) fever as defined by an axillary temperature > or =37.5degrees C, 2) accurate history of fever duration and the use of antibiotics 3) no previous history of UTI and 4) positive urine culture. We observed whether the longer fever duration could be associated with the development of initial renal defects and subsequent renal scars, increased C-reactive protein(CRP), leukocytosis and the presence of vesicoureteral reflux(VUR). RESULTS: 1) Patients with longer fever duration after antibiotics showed more frequent initial renal defects(P=0.014). However, fever duration before antibiotic use was not associated with the development of initial renal defects(P=0.244). 2)Incidence of renal scar increased with fever duration before antibiotic use(P=0.006) and fever duration after antibiotic use(P=0.015). 3) CRP correlated with the fever duration after antibiotic use(r=0.287, P=0.003). 4) There was no relationships between fever duration and VUR(P>0.05). CONCLUSIONS: Our data suggest that fever duration before/after antibiotic use is significantly associated with the increased development of renal scars in pediatric UTI.