Vesicoureteric reflux and renal scarring in Chinese children

Howard, R. G.; Roebuck, Derek; Yeung, Ps; Chan, KL; Metreweli, Constantine

doi:10.1259/bjr.74.880.740331

Cited by 29 publications

(16 citation statements)

References 15 publications

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“…In our study, boys with APN constituted a minority, a pattern similar to reports from Caucasian populations and contrary to the male predominance of UTI found in studies in Asian children [6,13,17]. The exact cause is not clear but early circumcision, commonly practiced in our male patients, may have a role in lowering the occurrence of UTI in boys.…”

Section: Discussionsupporting

confidence: 71%

“…Other ethnic groups reported different renal scarring prevalences, the highest being from Thailand and Ireland (59%), Taiwan (57%) and Brazil (55%) [11,12,13,14]. The lowest, yet still significant, were found in Australian 25%, Swedish (37%) and the Chinese children of Hong Kong (37%) [15,16,17]. Forty-four percent of a group of Indian children with APN developed renal scars on follow-up, a figure similar to ours [6].…”

Section: Discussionmentioning

confidence: 99%

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Acute pyelonephritis and renal scarring in Kuwaiti children: a follow-up study using 99mTc DMSA renal scintigraphy

et al. 2005

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The aim of this study was to determine the prevalence of renal scarring in a group of Kuwaiti Arab children with their first documented acute pyelonephritis (APN). Eighty-two Kuwaiti Arab children (10 males and 72 females) who had abnormal (99m)Tc DMSA renal scan findings of acute pyelonephritis were prospectively studied with the same imaging modality 6 months after treatment to identify those who developed renal scarring. A micturition cystourethrogram (MCUG) was performed for all of the children 1 month after diagnosis. Children were divided into 3 age groups (<2 years, 2-5 years and above 5 years). The follow-up DMSA renal scans 6 months after diagnosis revealed normalization of renal changes in 56% (46 patients), much improvement with residual renal abnormality in 6% (5 patients), and persistent parenchymal defects in 38% (31 patients). Vesicoureteric reflux (VUR) was found in 32% of children (26/82) and the majority were between grade I and III. Thirteen of those with VUR (50%) developed renal scars on follow-up. Fifty-three percent of the scarred kidneys (19/36) were drained by non-refluxing ureters. In this study, children older than 2 years had less VUR yet were more susceptible to APN and to the development of renal scars. Girls were more prone to developing APN and renal scarring than boys. This work shows that APN is a serious cause for renal scarring in our patients, particularly if associated with other risk factors such as recurrent infections and the female sex.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Acute pyelonephritis and renal scarring in Kuwaiti children: a follow-up study using 99mTc DMSA renal scintigraphy

et al. 2005

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“…In a study by Howard et al found 28% of boys with UTI had pyelonephritis. [7][8][9] In our study vesicoureteric reflux was noticed in 29.68% of children with first UTI who are younger than 5 years. In children above 5 years reflux was found in 7.14% of children.…”

Section: Discussionsupporting

confidence: 48%

Role of imaging in children with urinary tract infections

Sundar

Chinnasami

Sadasivam

et al. 2017

Int J Contemp Pediatr

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Background: As per recommendation from the American Academy of pediatrics a child with first episode of urinary tract infection should be evaluated for underlying urinary tract abnormalities by undergoing voiding cystourethrogram, ultrasonogram of urinary tract and radionuclide imaging of kidney. We studied role of these imaging studies in picking up renal abnormalities.Methods: We conducted a descriptive study in which 100 children aged 1mth-12 years with documented urinary tract infection (UTI) were included. Ultrasonogram (USG) and radionuclide renal scan were obtained at the time of admission. Voiding cystourethrography (VCUG) was performed after 6weeks to look for vesicoureteric reflux.Results: Forty three children underwent both DMSA and follow up VCUG. Ultrasonogram picked up acute pyelonephritis (APN) in 7.1% of children with UTI while 31.1% had pyelonephritis on DMSA. Overall incidence of VUR was 16.3%. The sensitivity of USG for VUR detection was only 14.2%. The sensitivity of USG as a screening test for APN is 7%.Conclusions: All children less than five years with UTI must undergo DMSA and VCUG. Ultrasonography is less sensitive in detecting VUR and acute pyelonephritis.

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“…In other countries with a predominately Caucasian population (Sweden and Australia), the prevalence is lower (24%-27%) [11,12]. Howard et al [13] reported the presence of VUR in 39% of symptomatic Chinese children with UTI. In our series of Arab children from Kuwait with first febrile UTI, VUR was present in 22% of patients.…”

Section: Discussionmentioning

confidence: 99%

Vesicoureteric reflux in Kuwaiti children with first febrile urinary tract infection

et al. 2003

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The prevalence of vesicoureteric reflux (VUR) in children with urinary tract infection (UTI) varies among different racial groups. The purpose of this study was to determine the frequency of VUR and associated renal changes in a group of Arab Kuwaiti children with their first documented febrile UTI and to compare our findings with those reported from other racial groups. One hundred and seventy-four children (38 males and 136 females) fulfilled the study criteria and were divided into three age groups (<1 year, 1-5 years, and >5 years). Patients in each group had both micturating cystourethrography (MCUG) and 99m-Tc-dimercaptosuccinic acid (DMSA) renal scan after diagnosis. VUR was detected in 39 children (22%). Two-thirds of cases had mild reflux (grade I and II). Females ( n=32) had more reflux than males ( n=7) (24% vs. 18%). Sixty-three patients (36%) had abnormal (DMSA) renal scans (acute pyelonephritis [AP] or renal scars). Of these, 79% were children below 5 years. Abnormal DMSA scans were found in 4 of 38 males (11%) versus 59 of 136 females (43%). Abnormal scans in children with VUR were seen in 1 of 7 males (14%) versus 19 of 32 females (59%). In total, the combination of abnormal scan with VUR occurred in 1 of 38 males (3%) and in 19 of 136 females (14%), whereas abnormal scan without demonstrable VUR was seen in 3 of 38 males (8%) versus 40 of 136 females (29%). Our data showed that the frequency of VUR in Arab Kuwaiti children with febrile UTI is midway between Caucasian and other racial groups. In this study, males had a lower-risk profile than females, the latter having a higher rate of reflux as well as a higher rate of abnormal DMSA scans, irrespective of demonstrable VUR.

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Vesicoureteric reflux and renal scarring in Chinese children

Cited by 29 publications

References 15 publications

Acute pyelonephritis and renal scarring in Kuwaiti children: a follow-up study using 99mTc DMSA renal scintigraphy

Acute pyelonephritis and renal scarring in Kuwaiti children: a follow-up study using 99mTc DMSA renal scintigraphy

Role of imaging in children with urinary tract infections

Vesicoureteric reflux in Kuwaiti children with first febrile urinary tract infection

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