ABSTRACTS PRESENTADOS AL 11th INTERNATIONAL SYMPOSIUM "RADIONUCLIDES IN NEPHRO-UROLOGY", REALIZADO EN MONTEREY, CALIFORNIA, 13-17 MAYO 2001.

Orellana P, Baquedano P, Cavagnaro F, Lagomarsino E., García C.

School of Medicine. Catholic University of Chile.

pilar@med.puc.cl

The purpose of this study was to define the correlation of renal scarring in patients with acute pyelonephritis (APN) with vesicoureteral reflux (VUR), age, gander, episode of UTI and delay on start antibiotic therapy. We prospective evaluate 96 children with APN and without urinary tract anomalies, 65 girls, with a mean age of 2.65 y.o. Forty seven out of 96 children were studied during the first proven urinary tract infection (UTI). Regarding the age, we classified the children in younger than 1 year old: 38 children, 1-5 years old: 42 children and older than 5 years old 16 children. VUR was confirmed in 39 children (40.6%). All children had an acute abnormal renal scan. Follow up scan was performed after six month of the acute episode, with an average of 9.02 months. We considered the scan evolution as normal (disappearance of abnormalities), improvement (focal defect uptake of less size, better relative renal function) or unchanged (without significant modifications).

We correlated the scintigraphic evolution with age, gender, episode of UTI, presence and grade of VUR and delay in treatment.
There was a complete normalization in the renal scan in 47 (48.9%) out of the 96 children, an improvement in 26 (27.1%) and no changes in 23 (23.9%). There were not significant differences regarding age. 43% of the girls and 61.3% of the boys showed normalization during the follow-up.

Regarding the episode of UTI, 57.4% of the group studied after the first proven UTI showed normalization and 40.8% of the children with recurrent UTI. Normalization of acute renal abnormalities was found in 51.7 % of children without VUR and 43.5% of those with VUR. The delay between symptoms and treatment in the group of children that showed normalization of acute renal abnormalities was 5.75 days, 4.52 days in children that showed improvement and 2.9 days in those with no changes. In our group we did not find any significant risk factor for developing renal scar after acute pyelonephritis.

(*)Part of the CRP "Study of the relationship between VUR, Pyelonephritis and renal scarring in children with urinary tract infection using nuclear medicine techniques". IAEA