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Journal of the Korean Society of Pediatric Nephrology 2010;14(1): 71-78. doi: https://doi.org/10.3339/jkspn.2010.14.1.71
발열성 요로 감염 환아에서 발견된 수신증의 임상적 의의
오정민, 이나라, 임형은, 유기환, 홍영숙, 이주원
1고려대학교 의과대학 소아과학교실
2고려대학교 의과대학 소아과학교실
3고려대학교 의과대학 소아과학교실
4고려대학교 의과대학 소아과학교실
5고려대학교 의과대학 소아과학교실
6고려대학교 의과대학 소아과학교실
Clinical Significance of Hydronephrosis in Febrile Urinary Tract Infection
Jung-Min Oh, Na-Ra Lee, Hyung-Eun Yim, 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 Pediatrics, College of Medicine, Korea University
5Department of Pediatrics, College of Medicine, Korea University
6Department of Pediatrics, College of Medicine, Korea University
Received: March 28, 2010;  Revised: April 14, 2010.  Accepted: April 23, 2010.
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ABSTRACT
Purpose : Hydronephrosis is found about 30% of children with urinary tract infection (UTI). It can be caused by various conditions, although most childhood hydronephrosis is congenital. This study was performed to investigate the relationship between febrile UTI and hydronephrosis.
Methods : We retrospectively reviewed the medical charts of 183 patients diagnosed as UTI between January 2007 and May 2009 at Korea University Guro Hospital. Inclusion criteria were as followings; 1) fever more than $37.5^{circ}C$ measured in the axilla, 2) positive urine culture, 3) no history of urinary tract anomaly on antenatal sonography and urinary tract infection. We classified the enrolled children into two groups of patients with hydronephrosis (HN) and those without hydronephrosis (NHN).
Results : The 80 patients were HN and 103 patients NHN. Hydronephrosis was found in 58 patients with left kidney, 8 right and 14 both kidneys. Most of hydronephrosis were of low grade. Compared with NHN group, initial renal cortical defects on DMSA scan significantly increased in HN group (HN 37.5%, NHN 16.5%, P<0.05). The incidence of VUR was not different between the two groups (HN 22%, NHN 12.1%). White blood cell counts and C-reactive protein were not different between the two groups. Follow-up DMSA scan (about 6 months later after UTI) showed no difference of renal scarring in both two groups.
Conclusion : Our data suggests that hydronephrosis in febrile UTI patients is clinically useful for detecting renal cortical defects, but is not associated with follow-up renal scar.
Key words: Hydronephrosis | Urinary tract infection | DMSA scan | Renal cortical defect
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