Predictive score for vesicoureteral reflux in children with a first febrile urinary tract infection

Lertdumrongluk, Kanita; Lertdumrongluk, Paungpaga

doi:10.1111/iju.14515

Cited by 8 publications

(15 citation statements)

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“…Of the 29 included studies, 9 studies were published between 2000 and 2010, whereas 20 studies were published between 2011 and 2022 (Table). Nineteen studies were retrospective, and 10 studies were prospective cohorts. No randomized clinical trials or cohort studies compared kidney ultrasonography with first febrile UTI vs targeted strategies (eg, deferring until second febrile UTI).…”

Section: Resultsmentioning

confidence: 99%

“…The study sample size ranged from 66 to 820 children (median, 300 children). Of the 21 studies that reported the causative bacteria, Escherichia coli was the main causative bacteria (median, 86% [range, 67%-96%]). Fifteen of 25 studies that included data on kidney ultrasonography timing reported performing ultrasonography during the hospital admission or within a week after diagnosis of UTI.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies 46,50 did not report criteria for the diagnosis of UTI (eTable 4 in Supplement 1). Twenty-three studies 14,19,[29][30][31][32][33][34][35][36][37][39][40][41][42][43][44]48,[50][51][52][53][54] reported criteria for abnormalities seen on kidney ultrasonography, and 10 studies 19,29,32,37,38,41,42,46,48,51 reported criteria and/or a grading system for hydronephrosis, of which 6 studies 19,29,37,40,42,48 used the Society of Fetal Urology system (eTable 5 in Supplement 1). 56 No study reported a statistical analysis plan for prevalence with 95% CIs.…”

Section: Quality Assessmentmentioning

confidence: 99%

“…Of the 29 included studies, 9 studies 14,30,41,[48][49][50][51][52][53] were published between 2000 and 2010, whereas 20 studies 19,29,[31][32][33][34][35][36][37][38][39][40][42][43][44][45][46][47]54,55 were published between 2011 and 2022 (Table ). Nineteen studies [29][30][31][32][33][36][37][38]40,41,43,44,[46][47][48][49][53][54][55] were retrospective, and 10 studies 14,19,34,35,39,…”

Section: Study Characteristicsmentioning

confidence: 99%

“…No randomized clinical trials or cohort studies compared kidney ultrasonography with first febrile UTI vs targeted strategies (eg, deferring until second febrile UTI). Twenty-four studies 19,[29][30][31][32]35,36,[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53]55 were conducted in children hospitalized for UTI, 1 in children exclusively in an ambulatory setting, 14 and 3 in both settings. 33,34,37 Fifteen studies 14,18,29,30,[34][35][36][37][42][43][44]46,48,52,53 only included children younger than 24 months.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Kidney Ultrasonography After First Febrile Urinary Tract Infection in Children

et al. 2023

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ImportanceControversy exists on the clinical utility of kidney ultrasonography after first febrile urinary tract infection (UTI), and clinical practice guideline recommendations vary.ObjectiveTo determine the prevalence of urinary tract abnormalities detected on kidney ultrasonography after the first febrile UTI in children.Data SourcesThe MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials databases were searched for articles published from January 1, 2000, to September 20, 2022.Study SelectionStudies of children with first febrile UTI reporting kidney ultrasonography findings.Data Extraction and SynthesisTwo reviewers independently screened titles, abstracts, and full texts for eligibility. Study characteristics and outcomes were extracted from each article. Data on the prevalence of kidney ultrasonography abnormalities were pooled using a random-effects model.Main Outcomes and MeasuresThe primary outcome was prevalence of urinary tract abnormalities and clinically important abnormalities (those that changed clinical management) detected on kidney ultrasonography. Secondary outcomes included the urinary tract abnormalities detected, surgical intervention, health care utilization, and parent-reported outcomes.ResultsTwenty-nine studies were included, with a total of 9170 children. Of the 27 studies that reported participant sex, the median percentage of males was 60% (range, 11%-80%). The prevalence of abnormalities detected on renal ultrasonography was 22.1% (95% CI, 16.8-27.9; I2 = 98%; 29 studies, all ages) and 21.9% (95% CI, 14.7-30.1; I2 = 98%; 15 studies, age &lt;24 months). The prevalence of clinically important abnormalities was 3.1% (95% CI, 0.3-8.1; I2 = 96%; 8 studies, all ages) and 4.5% (95% CI, 0.5-12.0; I2 = 97%; 5 studies, age &lt;24 months). Study recruitment bias was associated with a higher prevalence of abnormalities. The most common findings detected were hydronephrosis, pelviectasis, and dilated ureter. Urinary tract obstruction was identified in 0.4% (95% CI, 0.1-0.8; I2 = 59%; 12 studies), and surgical intervention occurred in 1.4% (95% CI, 0.5-2.7; I2 = 85%; 13 studies). One study reported health care utilization. No study reported parent-reported outcomes.Conclusions and RelevanceResults suggest that 1 in 4 to 5 children with first febrile UTI will have a urinary tract abnormality detected on kidney ultrasonography and 1 in 32 will have an abnormality that changes clinical management. Given the considerable study heterogeneity and lack of comprehensive outcome measurement, well-designed prospective longitudinal studies are needed to fully evaluate the clinical utility of kidney ultrasonography after first febrile UTI.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Quality Assessmentmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

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Kidney Ultrasonography After First Febrile Urinary Tract Infection in Children

et al. 2023

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Surgical management of high‐grade vesicoureteral reflux in an 18‐month‐old female with a solitary kidney: A case report from a resource‐limited setting

Nhungo,

Mwakalukwa,

Wambura

et al. 2024

Clinical Case Reports

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Key Clinical MessageConservative nonsurgical therapy ensures that the resolution is nearly 80% for vesicoureteral reflux grades I and II and 30%–50% for vesicoureteral reflux grades III and V within 4–5 years of follow‐up. Open surgical reimplantation of ureters of grades IV and V is a highly successful procedure, with reported correction rates ranging from 95% to 99% regardless of the severity of vesicoureteral reflux.AbstractPatients with vesicoureteral reflux present with a wide range of severity. With an incidence of approximately 1%, vesicoureteral reflux is a relatively common urological abnormality in children. Postnatal diagnosis of vesicoureteral reflux is typically made following a diagnosis of a urinary tract infection and less frequently following family screening. Voiding cystourethrograms remain the gold standard for diagnosing vesicoureteral reflux. To preserve the kidney and prevent the need for potential renal replacement therapy, infants with a single kidney require significantly more assessments and prompt decision‐making. Surgical correction is advised for patients with vesicoureteral reflux grades IV and V, while vesicoureteral reflux grades I, II, and III are managed conservatively.

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Pyelonwandverdickung zur Vorhersage eines vesikoureteralen Refluxes

Reichert

2021

Monatsschr Kinderheilkd

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Predictive score for vesicoureteral reflux in children with a first febrile urinary tract infection

Cited by 8 publications

References 30 publications

Kidney Ultrasonography After First Febrile Urinary Tract Infection in Children

Kidney Ultrasonography After First Febrile Urinary Tract Infection in Children

Surgical management of high‐grade vesicoureteral reflux in an 18‐month‐old female with a solitary kidney: A case report from a resource‐limited setting

Pyelonwandverdickung zur Vorhersage eines vesikoureteralen Refluxes

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