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ISSN 1561-3119 (Electronic)

2015, Number 4

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Rev Cubana Pediatr 2015; 87 (4)

Factors associated to permanent renal damage in children with first febrile urinary tract infection

Martínez SM, Duarte PMC, Guillén DA, Acosta MEC

Language: Spanish
References: 28
Page: 413-422
PDF size: 132.81 Kb.


ABSTRACT

Introduction: the patients with febrile urinary tract infection may develop permanent renal damage and face future complications.
Objective: to determine the factors associated to permanent renal damage in patients with first febrile urinary tract infection.
Methods: prospective longitudinal study of 235 pediatric patients admitted to hospital with first febrile urinary tract infection in the period of May 2007 through December 2011. The study variables were age, sex, duration and intensity of fever, global blood leukocyte count, globular sedimentation velocity, C-reactive protein, renal and vessical ultrasound, vesicoureteral reflux, etiological agent, DMSA Tc99m renal scintigraphy at acute and evolutionary stage. The association of permanent renal damage and the study variables was analyzed.
Results: of 125 patients with scintigraphic alterations at acute phase of infection, 50 showed findings compatible with permanent renal damage and confirmed in the evolutionary scintigraphy, which accounted for 21.3 % of studied patients and 40 % of cases with acute pyelonephritis; 40 were younger than one year-old. No statistical significant association of this disease with age, sex, duration and intensity of fever was confirmed. Leukocyte count over 15,000/mL and permanent renal damage were significantly associated (p=0,009). Vesicoureteral reflux was present in 65.6 % of cases and the risk of permanent renal damage was greater in those patients in whom a microorganism other than E.coli was isolated.
Conclusions: leukocyte count of 15 000/mL or higher, vesicoureteral reflux and infection caused by microorganisms other than E.coli are independently associated with the presence of renal scarring when applying the logistic regression.


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