Role of Imaging in Identifying Various Renal Lesions in Children Less Than 5 Years Presenting with First Febrile Urinary Tract Infections

Abstract

Febrile Urinary Tract Infections (UTI) is one of the common causes of infections in children. Unrecognized and untreated UTIs may lead to renal scarring of the growing kidneys with subsequent renal failure. Objectives: To compare the effectiveness of USG to detect vesicoureteric reflex confirmed by micturating cystourethrogram (MCU) and renal parenchymal abnormalities confirmed by dimercaptosuccinic acid scan (DMSA) between 1 month to 59 months of age. Methods: A prospective observational study was done at a tertiary care centre to study the imaging correlation in children with the first episode of febrile UTI. Ultrasonography Kidney-Urinary-Bladder (USG-KUB), MCU, and DMSA were done according to the Indian Academy of Paediatrics protocol after getting informed consent from parents. Results:  USG showed a perfect concordance with MCU in detecting VUR (100% sensitivity and specificity) and had a high sensitivity (94.1%) and specificity (100%) in detecting renal parenchymal abnormalities when compared to DMSA in less than 1 year old. It also showed a sensitivity of 85.4% and specificity of 100% in detecting renal parenchymal abnormalities when compared to DMSA in children aged 1-5 years. Conclusion: Overall, the results of this research article indicate that USG shows promising diagnostic accuracy as a non-invasive imaging modality in detecting VUR and renal parenchymal abnormalities across different age groups presenting with febrile UTI.To study the effectiveness of USG in detecting vesicoureteric reflex confirmed by micturating cystourethrogram and renal parenchymal abnormalities confirmed by dimercaptosuccinic acid scan (DMSA) in children with first episode febrile UTI. Short title: Role of imaging in children with first episode febrile UTI.