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Scientific article
English

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

Contributors

Parvex, Paloma; Willi, Jean-Pierre; Kossovsky, Michel; Girardin, Eric

Published in

The Journal of urology, vol. 180, no. 6, p. 2602-2606;discussion2606

Publication date

2008

Abstract

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.

Keywords

  • Acute Disease
  • Adolescent
  • Child
  • Child, Preschool
  • Cicatrix/etiology/radionuclide imaging
  • Disease Progression
  • Female
  • Humans
  • Infant
  • Kidney/growth & development/radionuclide imaging
  • Kidney Diseases/etiology/radionuclide imaging
  • Male
  • Prospective Studies
  • Pyelonephritis/complications/radionuclide imaging
  • Radiopharmaceuticals/diagnostic use
  • Technetium Tc 99m Dimercaptosuccinic Acid/diagnostic use

UNIGE affiliation entities

UNIGE research groups

Citation (ISO format)

PARVEX, Paloma et al. Longitudinal analyses of renal lesions due to acute pyelonephritis in children and their impact on renal growth. In: The Journal of urology, 2008, vol. 180, n° 6, p. 2602–2606;discussion2606. doi: 10.1016/j.juro.2008.08.059

Main files (1)

Article (Published version)

Identifiers

Journal ISSN

0022-5347
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Technical informations

Creation

07/04/2009 10:06:00

First validation

07/04/2009 10:06:00

Update

14/03/2023 15:04:21

Status update

14/03/2023 15:04:21

Last indexation

29/10/2024 11:27:49
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