Does the postnatal detection of renal pelvis dilation a higher risk of urinary tract infection?
Authors:
H. Flögelová 1; O. Šmakal 2; J. Hálek 3; K. Michálková 4; V. Švecová 4; J. Zapletalová 5
Authors‘ workplace:
Dětská klinika FN a LF UP, Olomouc
přednosta prof. MUDr. V. Mihál, CSc.
1; Urologická klinika FN a LF UP, Olomouc
přednosta doc. MUDr. V. Študent, Ph. D.
2; Novorozenecké oddělení FN, Olomouc
primář MUDr. L. Kantor, Ph. D.
3; Radiologická klinika FN, Olomouc
přednosta prof. MUDr. M. Heřman, Ph. D.
4; Ústav lékařské biofyziky Univerzity Palackého, Olomouc
přednostka prof. RNDr. H. Kolářová, CSc.
5
Published in:
Čes-slov Pediat 2012; 67 (4): 223-228.
Category:
Original Papers
Overview
Objective:
The authors investigated, whether children with renal pelvis dilation observed during a screening postnatal ultrasound examination represent a higher risk of febrile infection of urinary tract in the first two years of life as compared to children with a normal ultrasound finding.
Methods:
In the period of 2005 to 2008, ultrasound examination of the kidneys was performed prospectively in 6,088 in complete population of healthy newborns at the Faculty Hospital in Olomouc. All children with renal pelvis dilation higher than 5 mm measured in anterior-posterior intrarenal projection (APIR) were further investigated. These 236 children were divided into 4 groups according to renal pelvis dilation size (5–7 mm, 7–10 mm, 10–15 mm, ≥15 mm). The occurrence of febrile infection of urinary tract, obstructive uropathy and vesicoureteral reflux were investigated. In all remaining children of the basic cohort (5,852 children with normal ultrasound examination) we followed, whether they were hospitalized or treated in outpatient departments in the first two years of life for febrile infection of urinary tract. The statistical examination used chi-square test, Fisher exact test and the relative risk test.
Results:
The febrile infection of urinary tract in children with normal ultrasound of the kidneys occurred in 1.2%. In children with postnatal renal pelvis dilation of 5 mm or more the occurrence was 6.8% which proved to be significantly higher (p<0.0001). In the individual groups classified according to renal pelvis dilation the febrile infection of urinary tract was 6.2% in APIR 5–7 mm (p=0.0005), in 5.7% in APIR of 7–10 mm (p=0.044), in 13.3% in APIR 10–15 mm (p=0.056, non-significant) and in 20% in APIR 15 mm and more (p=0.237, non-significant difference).
The relative risk of occurrence of the febrile infection of urinary tract above 5 mm vs. below 5 mm, the relative ratio was 5.67 (95% CI 3.20–9.80).
Conclusion:
In our cohort the children with the postnatal detection of renal pelvis dilation there was a significantly higher risk of febrile infection of urinary tract in the first two years of life as compared to children with a normal ultrasound finding in the kidneys.
Key words:
renal pelvis dilation, infection of urinary tract, postnatal ultrasound screening
Sources
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Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2012 Issue 4
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