Abstract

DUARTE PEREZ, María Caridad; GUILLEN DOSAL, Ana; MARTINEZ SILVA, Magalys  and  DIAZ ALVAREZ, Manuel. Prediction of brain damage in patients with initial febrile infection of urinary tract. Rev Cubana Pediatr [online]. 2011, vol.83, n.2, pp. 120-129. ISSN 1561-3119.

INTRODUCTION. The urinary tract infection (UTI) is one of the more frequent bacterial infections in early childhood. The objective of present research was to identify the risk factors of the lasting renal damage in patients with febrile UTI. METHODS. A prospective study was conducted including 100 children with a clinical and microbiologic diagnosis of febrile UTI who underwent a renal scintigraph using Tc99m DMSA in the acute phase of infection (those with scintigraph alterations underwent a second assessment at 9 to 12 months after acute infection). Authors research the relation of first and second scintigraph results with the length and intensity of fever before diagnosis and treatment, the acute phase reactants (white cell count, globular erythrosedimentation and reactive C protein [RCP]) as well as the radiologic studies (renal echography and miction urethrocystography). RESULTS. There was female sex predominance and the 86% of patients were under one year old. The 58% of children had acute scintigraph alterations and the radiopharmaceutical focal hypocaptation was the more predominant finding in the 75,8% of patients. The RPC was the only variable associated significantly with acute renal alterations. The 20% of patients had lasting renal damage and from the variables used, only the accelerated erythrosedimentation and relative renal function (RRF) ≤ 43% in the first scintigraph had statistic significance in relation to presence of renal scar. CONCLUSIONS. A high percentage of patients had spread of infection to renal parenchyma and the RCP was the only variable related to acute alterations. It was demonstrated the presence of lasting renal damage in the 20% of patients and erythrosedimentation and the RRF lowered were the variables with statistic significance for this entity.

Keywords : Lasting renal damage; urinary tract infection; renal scintigraph.

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