All issues > Volume 44(1); 2001

Original Article

J Korean Pediatr Soc. 2001;44(1):54-61. Published online January 15, 2001.

Risk Factors of Renal Scar After Acute Pyelonephritis in Children

Chur Woo CW You¹

¹Department of Pediatrics, Sung Kyunn kwan University College of Medicine, Masan Samsung Hospital, Masan, Korea

Correspondence Chur Woo CW 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.

Keywords :Acute pyelonephritis, 99mTc-DMSA renal scan, Renal scar, Risk factors