Τίτλος:
Clinical and laboratory indices of severe renal lesions in children with febrile urinary tract infection
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Aim To evaluate the predictive value of various clinical and laboratory parameters on the identification of acute extensive and/or multifocal renal involvement in children with febrile urinary tract infections (UTI). Methods The medical records of 148 children (median age: 2.4 months, range: 11 days-24 months), who were admitted during a 3-year period with a first episode of febrile UTI, were analysed. Acute dimercaptosuccinic acid scintigraphy (DMSA), 1clinical and laboratory parameters were evaluated. Results Seventy six children (51%) had abnormal findings on the acute DMSA. Of them, 20 had DMSA grade 2, while 56 had grade 3 and 4. Patients with a DMSA grade 3 and 4 were more likely to have shivering (OR 3.4), white blood count (WBC) ≥ 18 000/μL (OR 2.4), absolute neutrophil count (ANC) ≥ 9300/μL (OR 4.4), C-reactive protein (CRP) ≥ 50 mg/L (OR 2.7) and procalcitonin (PCT) ≥ 1.64 ng/mL (OR diagnostic). There was a significant difference of WBC (p = 0.004), ANC, CRP and PCT levels (p < 0.001) between children with normal and grade 2 aDMSA versus those with aDMSA grade 3 and 4. Conclusions Shivering and elevated inflammatory markers increase the risk of acute extensive and/or multifocal kidney involvement in children with febrile UTI. Procalcitonin seems to be an excellent marker of the severity of acute parenchymal involvement. ©2014 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.
Συγγραφείς:
Koufadaki, A.M.
Karavanaki, K.A.
Soldatou, A..
Tsentidis, Ch.
Sourani, M.P.
Sdogou, T.
Haliotis, F.A.
Stefanidis, C.J.
Περιοδικό:
Acta Paediatrica, International Journal of Paediatrics
Εκδότης:
Wiley-Blackwell Publishing Ltd
Λέξεις-κλειδιά:
antibiotic agent; C reactive protein; procalcitonin; succimer, abnormal laboratory result; absolute neutrophil count; acute pyelonephritis; antibiotic therapy; article; body temperature disorder; child; childhood disease; clinical assessment; clinical feature; clinical laboratory; dimercaptosuccinic acid scintigraphy; disease association; disease severity; febrile urinary tract infection; female; human; infant; kidney injury; kidney scintiscanning; laboratory diagnosis; leukocyte differential count; major clinical study; male; medical record review; neutrophil count; newborn; predictive value; priority journal; retrospective study; shivering; urinary tract infection; diagnostic procedure; evaluation study; fever; microbiology; pyelonephritis; severity of illness index; Urinary Tract Infections, Clinical Laboratory Techniques; Female; Fever; Humans; Infant; Infant, Newborn; Male; Predictive Value of Tests; Pyelonephritis; Retrospective Studies; Severity of Illness Index; Urinary Tract Infections
