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Risk Factors of Renal Scar After Acute Pyelonephritis in Children

Journal of the Korean Pediatric Society 2001;44(1):54-61.
Published online January 15, 2001.
Risk Factors of Renal Scar After Acute Pyelonephritis in Children
Chur Woo You
Department of Pediatrics, Sung Kyunn kwan University College of Medicine, Masan Samsung Hospital, Masan, Korea
소아의 급성 신우신염 후 신반흔 형성의 위험인자
유철우
성균관대학교 의과대학 마산삼성병원 소아과
Correspondence: 
Chur Woo You, Email: cwy1@unitel.co.kr
Abstract
Purpose
: In this study we re-evaluated the known risk factors of pyelonephritic scarring in children.
Methods
: A prospective study was performed on 36 acute pyelonephritis(APN) patients who were diagnosed as first acute pyelonephritis on 99mTc-DMSA scan between September 1998 and March 2000 in Masan Samsung Hospital. According to the prescence of remnant lesions on the 99mTc-DMSA scan performed 6 months after the first 99mTc-DMSA scan, the patients were divided into scar(Group A, N=15) and non-scar groups(Group B, N=21). We compared known risk factors of renal scarring between the two groups.
Results
: There were no differences in age, sex, cultured organisms and CRP level between the two groups. Most of the initial 99mTc-DMSA scan results were not different but bilateral multiple lesions were much more common in group A(40.0% of Group A patients) compared with group B (9.5% of Group B patients). Moderate to high grade vesicoureteral reflux was also much more commonly observed in group A(46.6% of Group A patients) compared with group B(4.8% of Group B patients).
Conclusion
: Bilateral multiple lesion on initial 99mTc-DMSA scan and moderate to high grade vesicoureteral reflux at diagnosis of acute pyelonephritis may be risk factors associated with renal scarring after acute pyelonephritis in children.
Key Words: Acute pyelonephritis, 99mTc-DMSA renal scan, Renal scar, Risk factors


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