Pred iction of High Grade Vesicoureteral Reflux in Infants Less than 3 Months with Urinary Tract Infection.
- Author:
Dae Yong YI
1
;
Na Yeon KIM
;
Hee Yeon CHO
;
Ji Eun KIM
;
So Yeon SIM
;
Dong Woo SON
;
In Sang JEON
;
Han CHA
Author Information
1. Department of Pediatrics, Gachon University of Medicine and Science, Korea. simso525@hanmail.net
- Publication Type:Original Article
- Keywords:
Urinary tract infection;
Vesicoureteral reflux;
Ultrasonography
- MeSH:
Bacteremia;
Humans;
Incidence;
Infant;
Male;
Odds Ratio;
Prednisolone;
Retrospective Studies;
Sensitivity and Specificity;
Succimer;
Urinary Tract;
Urinary Tract Infections;
Vesico-Ureteral Reflux
- From:Journal of the Korean Society of Pediatric Nephrology
2008;12(2):178-185
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Our aim was to investigate the predictive factors for detecting grade III-V vesicoureteral reflux(VUR) in young infants less than 3 months with urinary tract infections (UTI). METHODS: Data of infants who underwent ultrasonography and VCUG between January 2004 and September 2007 were reviewed. Age, gender, incidence of bacteremia, C-reactive protein(CRP) and imaging studies were compared between group I(grade III-V VUR) and group II (normal or grade I and II VUR) retrospectively. Sensitivity, specificity, positive and negative predictive values, odds ratio, and likelihood ratio of ultrasonography for high grade VUR were evaluated. RESULTS: Among 54 enrolled infants(41 males, 13 females), 14 infants were group I and 40 infants were group II. In the group I, CRP level was significantly higher(6.11+/-5.18 vs. 3.27+/-3.45, P=0.025), and there were more ultrasonographic abnormal findings(71.4%, vs. 22.5%, P=0.002) compared with group II. However, ultrasonography was the only significant factor after adjusting with logistic regression(P=0.002). Incidence of bacteremia and abnormal DMSA findings were not significantly different in two groups. Sensitivity, specificity, and odds ratio of ultrasonography was 71.4%, 77.5%, 6.9 respectively. Negative predictive value was 88.6% and negative likelihood ratio was 0.37. Ultrasonography had significant negative likelihood ratio for grade III-V VUR, but missed 4 infants with grade III VUR. CONCLUSION: We could not find any alternative predictive factors to reduce VCUG in detecting high grade VUR. Therefore, VCUG must be considered in young infants less than 3 months with UTI.
