Selective imaging modalities after first pyelonephritis failed to identify significant urological anomalies, despite normal antenatal ultrasounds

Abstract

Dilated VUR was the dominant anomaly in a cohort with first time pyelonephritis and normal antenatal ultrasound. The optimal imaging strategy after pyelonephritis must be identified.

Children with acute pyelonephritis need medical re‐evaluation when home‐treated with oral antibiotics

“…This finding is in accordance with the literature. 14,19 It was not possible to identify predictors for those children requiring hospitalization and intravenous treatment, but children with a previous UTI had a tendency to be changed to intravenous antibiotics. In general, oral antibiotic treatment is not recommended for pyelonephritis in children with known urological anomalies.…”

“…An ultrasound of the kidneys and urinary tract was performed within the first months after the diagnosis of pyelonephritis. Dilated renal pelvis was defined as an anterior‐posterior diameter of at least 10 mm, and a difference in the length of the kidneys of more than one cm was categorised as an anomaly 19 . We could have repeated the ultrasound to see if the difference in kidney size depended on swelling from the UTI or congenital hypoplasia, but in this multicenter study we unfortunately did not have data on that.…”

“…Some departments additionally performed renal scintigraphy either a technetium‐99m mercaptoacetyltriglycine renography (MAG3) or a technetium‐99m dimercaptosuccinic acid scintigraphy (DMSA) after the infection. Unilateral impaired renal function was defined as a renal differential function of less than 40%, based on the Danish guidelines and the European Society of Paediatric Urology (ESPU) guidelines 19 …”

“…Urine samples without significant growth n=179 n=35 n=12 n=179 Excluded 10 mm, and a difference in the length of the kidneys of more than one cm was categorised as an anomaly. 19 We could have repeated the ultrasound to see if the difference in kidney size depended on swelling from the UTI or congenital hypoplasia, but in this multicenter study we unfortunately did not have data on that. Some departments additionally performed renal scintigraphy either a technetium-99m mercaptoacetyltriglycine renography (MAG3) or a technetium-99m dimercaptosuccinic acid scintigraphy (DMSA) after the infection.…”

“…Unilateral impaired renal function was defined as a renal differential function of less than 40%, based on the Danish guidelines and the European Society of Paediatric Urology (ESPU) guidelines. 19…”