Ultrasonography and C-reactive protein can predict the outcomes of voiding cystography after the first urinary tract infection - Abstract

AIM: This study evaluated whether sex, clinical variables, laboratory variables or ultrasonography predicted the presence of vesicoureteric reflux during the first episode of urinary tract infection in paediatric patients.

We also aimed to define the criteria that indicated the need for voiding cystography testing.

METHODS: We used voiding cystography to investigate 200 patients who experienced their first urinary tract infection at our institution between 2004 and 2013 and retrospectively analysed the data by reviewing their medical records.

RESULTS: Sex (p = 0.001), peak blood C-reactive protein levels (p < 0.001), the duration of fever after antibiotic administration (p = 0.007) and the ultrasonography findings grade (p < 0.001) were significantly different between patients with and without vesicoureteric reflux. Grade IV-V ultrasonography findings and C-reactive protein levels of ≥80 mg/L predicted vesicoureteric reflux with a sensitivity, specificity and odds ratio of 47.8%, 87.8% and 6.59 (95% confidence interval = 3.26-13.33), respectively (p < 0.001).

CONCLUSION: Voiding cystography should be performed for patients with C-reactive protein levels of ≥80 mg/L and grade IV-V ultrasonography findings, but is not necessary in patients with C-reactive protein levels of < 80 mg/L and grade I-III ultrasonography findings.

Written by:
Kido J, Yoshida F, Sakaguchi K, Ueno Y, Yanai M.   Are you the author?
Department of Pediatrics, Kumamoto Regional Medical Center, Kumamoto City, Kumamoto, Japan; Department of Pediatrics, Graduate School of Medical Sciences, Kumamoto University, Kumamoto City, Kumamoto, Japan.


Reference: Acta Paediatr. 2015 May;104(5):e216-21.
doi: 10.1111/apa.12941

PubMed Abstract
PMID: 25620637

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