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Journal of the Korean Society of Pediatric Nephrology 2008;12(1): 70-77. doi: https://doi.org/10.3339/jkspn.2008.12.1.70
소아 요로감염에서 발열과 신반흔의 관계
정지인, 임동희, 임형은, 박만식, 유기환, 홍영숙, 이주원
1고려대학교 의과대학 소아과학교실
2고려대학교 의과대학 소아과학교실
3고려대학교 의과대학 소아과학교실
4고려대학교 의과대학 의학통계학교실
5고려대학교 의과대학 소아과학교실
6고려대학교 의과대학 소아과학교실
7고려대학교 의과대학 소아과학교실
Fever Duration and Renal Scar in Pediatric Urinary Tract Infection
Ji-In Jung, Dong-Hee Lim, Hyung-Eun Yim, Man-Sik Park, Kee-Hwan Yoo, Young-Sook Hong, Joo-Won Lee
1Department of Pediatrics, College of Medicine, Korea University
2Department of Pediatrics, College of Medicine, Korea University
3Department of Pediatrics, College of Medicine, Korea University
4Department of Biostatistics, College of Medicine, Korea University
5Department of Pediatrics, College of Medicine, Korea University
6Department of Pediatrics, College of Medicine, Korea University
7Department of Pediatrics, College of Medicine, Korea University
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ABSTRACT
Purpose: Urinary tract infections(UTIs) are not uncommon findings in febrile pediatric patients and approximately one third of patients with UTI may have renal scars. This research was intended to establish the relationship between duration of fever and renal scars.
Methods: The medical records of 143 patients were reviewed retrospectively. Inclusion criteria were as follows: 1) fever as defined by an axillary temperature $geq37.5^{circ}C$, 2) accurate history of fever duration and the use of antibiotics 3) no previous history of UTI and 4) positive urine culture. We observed whether the longer fever duration could be associated with the development of initial renal defects and subsequent renal scars, increased C-reactive protein(CRP), leukocytosis and the presence of vesicoureteral reflux(VUR).
Results : 1) Patients with longer fever duration after antibiotics showed more frequent initial renal defects(P=0.014). However, fever duration before antibiotic use was not associated with the development of initial renal defects(P=0.244). 2) Incidence of renal scar increased with fever duration before antibiotic use(P=0.006) and fever duration after antibiotic use(P=0.015). 3) CRP correlated with the fever duration after antibiotic use(r=0.287, P=0.003). 4) There was no relationships between fever duration and VUR(P>0.05).
Conclusion : Our data suggest that fever duration before/after antibiotic use is significantly associated with the increased development of renal scars in pediatric UTI.
Key words: Urinary tract infection | Fever | Scar | C-reactive protein | Leukocytes | Vesico-ureteral reflux
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