Longitudinal analyses of renal lesions due to acute pyelonephritis in children and their impact on renal growth.

Détails

ID Serval
serval:BIB_E86F4B41861B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Longitudinal analyses of renal lesions due to acute pyelonephritis in children and their impact on renal growth.
Périodique
Journal of Urology
Auteur(s)
Parvex P., Willi J.P., Kossovsky M.P., Girardin E.
ISSN
1527-3792[electronic]
Statut éditorial
Publié
Date de publication
2008
Volume
180
Numéro
6
Pages
2602-2606
Langue
anglais
Résumé
PURPOSE: Acute pyelonephritis is a common condition in children, and can lead to renal scarring. The aim of this study was to analyze the progression of renal scarring with time and its impact on renal growth. MATERIALS AND METHODS: A total of 50 children who had renal scarring on dimercapto-succinic acid scan 6 months after acute pyelonephritis underwent a repeat scan 3 years later. Lesion changes were evaluated by 3 blinded observers, and were classified as no change, partial resolution or complete disappearance. Renal size at time of acute pyelonephritis and after 3 years was obtained by ultrasound, and renal growth was assessed comparing z-score for age between the 2 measures. Robust linear regression was used to identify determinants of renal growth. RESULTS: At 6 months after acute pyelonephritis 88 scars were observed in 100 renal units. No change was observed in 27%, partial resolution in 63% and complete disappearance in 9% of lesions. Overall, 72% of lesions improved. Increased number of scars was associated with high grade vesicoureteral reflux (p = 0.02). Multivariate analysis showed that the number of scars was the most important parameter leading to decreased renal growth (CI -1.05 to -0.35, p <0.001), and with 3 or more scars this finding was highly significant on univariate analysis (-1.59, CI -2.10 to -1.09, p <0.0001). CONCLUSIONS: Even 6 months after acute pyelonephritis 72% of dimercapto-succinic acid defects improved, demonstrating that some of the lesions may be not definitive. The number of scars was significantly associated with loss of renal growth at 3 years.
Mots-clé
Acute Disease, Adolescent, Child, Child, Preschool, Cicatrix/etiology, Cicatrix/radionuclide imaging, Disease Progression, Female, Humans, Infant, Kidney/growth & development, Kidney/radionuclide imaging, Kidney Diseases/etiology, Kidney Diseases/radionuclide imaging, Male, Prospective Studies, Pyelonephritis/complications, Pyelonephritis/radionuclide imaging, Radiopharmaceuticals/diagnostic use, Technetium Tc 99m Dimercaptosuccinic Acid/diagnostic use
Pubmed
Web of science
Création de la notice
12/01/2010 10:57
Dernière modification de la notice
03/03/2018 22:21
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