Delayed treatment of the first febrile urinary tract infection in early childhood increased the risk of renal scarring

2016 ◽  
Vol 106 (1) ◽  
pp. 149-154 ◽  
Author(s):  
Kyriaki A. Karavanaki ◽  
Alexandra Soldatou ◽  
Athina Maria Koufadaki ◽  
Charalampos Tsentidis ◽  
Fotis A. Haliotis ◽  
...  
Author(s):  
Samuel Uwaezuoke ◽  
Adaeze Ayuk ◽  
Uzoamaka Muoneke

Urinary tract infection (UTI) is a significant cause of morbidity in children. Delayed treatment is associated with complications that may result in chronic kidney disease and, subsequently, end-stage kidney disease. Over the years, clinical practice guidelines have advanced to ensure the best global practices in treating the infection and preventing its progression to chronic kidney disease. The established practice guidelines address five main questions: 1) which children should have their urine tested; 2) how the sample should be obtained; 3) which radiological tests are recommended after a diagnosis of UTI; 4) how the infection should be treated; 5) and how affected children should be followed up. There is a substantial overlap in the recommendations of the American Academy of Pediatrics (AAP) guidelines and the UK’s National Institute for Health and Clinical Excellence (NICE) guidelines. Subtle differences, however, exist between the two established guidelines. An evidence-based paradigm shift of some traditional concepts about UTI in children has contributed to the revision and update of these guidelines. Further research is needed to clarify the role of host and genetic factors in renal scarring, as well as the diagnostic criteria for UTI. This narrative review aims to discuss the current recommendations of these established practice guidelines with an emphasis on the diagnosis, radiological investigation, treatment, and follow-up of UTI in children.


2017 ◽  
Vol 83 (3) ◽  
pp. 662-668 ◽  
Author(s):  
Sohsaku Yamanouchi ◽  
Takahisa Kimata ◽  
Jiro Kino ◽  
Tetsuya Kitao ◽  
Chikushi Suruda ◽  
...  

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Michaella M. Prasad ◽  
Earl Y. Cheng

The proper algorithm for the radiographic evaluation of children with febrile urinary tract infection (FUTI) is hotly debated. Three studies are commonly administered: renal-bladder ultrasound (RUS), voiding cystourethrogram (VCUG), and dimercapto-succinic acid (DMSA) scan. However, the order in which these tests are obtained depends on the methodology followed: bottom-up or top-down. Each strategy carries advantages and disadvantages, and some groups now advocate even less of a workup (none of the above) due to the current controversies about treatment when abnormalities are diagnosed. New technology is available and still under investigation, but it may help to clarify the interplay between vesicoureteral reflux, renal scarring, and dysfunctional elimination in the future.


2016 ◽  
Vol 170 (9) ◽  
pp. 848 ◽  
Author(s):  
Nader Shaikh ◽  
Tej K. Mattoo ◽  
Ron Keren ◽  
Anastasia Ivanova ◽  
Gang Cui ◽  
...  

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
Hans G. Pohl ◽  
A. Barry Belman

The evaluation of children presenting with urinary tract infection (UTI) has long entailed sonography and cystography to identify all urological abnormalities that might contribute to morbidity. The identification of vesicoureteral reflux (VUR) has been of primary concern since retrospective studies from the 1930s to 1960s established a strong association between VUR, recurrent UTI, and renal cortical scarring. It has been proposed that all VUR carries a risk for renal scarring and, therefore, all VUR should be identified and treated. We will not discuss the controversies surrounding VUR treatment in this review focusing instead on a new paradigm for the evaluation of the child with UTI that is predicated on identifying those at risk for scarring who are most deserving of further evaluation by cystography.


2015 ◽  
Vol 194 (3) ◽  
pp. 766-771 ◽  
Author(s):  
Tetsuya Kitao ◽  
Takahisa Kimata ◽  
Sohsaku Yamanouchi ◽  
Shogo Kato ◽  
Shoji Tsuji ◽  
...  

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