Tekrarlayan İdrar Yolu Enfeksiyonu Olan Çocuklarda Renal Skar Tespiti İçin Görüntüleme Yöntemlerinin Karşılaştırılması

ÖzGiriş:İdrar yolu enfeksiyonu 2 yaş altı çocuklarda ateş, bakteriyemi, sepsis ve organ yetmezliğinin sık ve önemli bir nedenidir. Tekrarlayan idrar yolu enfeksiyonunda mortalite ve morbiditeye neden olabilen üst üriner sistem enfeksiyonları, akut ve kronik renal yetersizliğin önlenebilmesi için risk faktörleri, tanı ve tedavi algoritmaları belirlenmelidir.Yöntem: Ocak 2005–Ocak 2010 tarihleri arasında hastanemizin Çocuk Nefroloji polikliniğindetekrarlayan idrar yolu enfeksiyonu tanısı ile izlenen 101 hasta retrospektif olarak değerlendirildi. Bu hastaların tam idrar tetkiki, idrar kültürü, üriner sistem ultrasonografisi (USG),voiding sistoüreterogram (VCUG) ve Tc-99m DMSA sintigrafi sonuçları kaydedildi.Bulgular: 101 olgunun %78.2’ si kız, %21.8’i erkek, %23.8 olguda USG’de renal parankimalhasar, %38.6 olguda VCUG’de reflü, %70.3 olguda DMSA sintigrafisinde skar ve ak-tivite kaybı tespit edilmiştir.Sonuç: VUR insidansı ve derecesi arttıkça renal skar sıklığının arttığı, VUR ile renal skararasında pozitif korelasyon olduğu tespit edilmiştir. Ayrıca tekrarlayan idrar yolu enfek-siyonu olan vakalarda renal hasarı göstermede en duyarlı görüntüleme yönteminin re-nal sintigrafi olduğu saptanmıştır.

Anahtar Kelimeler:

Tekrarlayan idrar yolu enfeksiyonu, vesikoüreteralreflü, renal skar

Comparison of Imaging Techniques in Detecting Renal Scars in Children with Recurrent Urinary Tract Infections

AbstractIntroduction Urinary tract infections (UTIs) are a frequent and important cause of fever, bacteremia, sepsis, and organ failure inchildren under two years of age. Severe infections that cause mortality and morbidity in recurrent urinary tract infections, risk factors, diagnosis, and treatment for the prevention of acute and chronic renal insufficiency should be well known.Methods: Between January 2005 and January 2010, a total of 101patients with recurrent urinary tract infection were evaluated retrospectively in the pediatric nephrology clinic of ourinstitution. Patient data were obtained retrospectively fromcharts in the hospital archives. The age, gender, demographics, physical examination findings, laboratory results, andimaging data were recorded.Results In a total of 101 cases, 78.2% of them were female, and21.8% of them were males. Renal parenchymal damage wasdetected in 23.8% of the cases using ultrasonography(USG), vesicoureteral reflux (VUR) was detected in 38.6%of the cases using voiding cystourethrography (VCUG),andrenal scars and activity loss was detected in 70.3% of thecases using Tc-99m dimercaptosuccinic acid (DMSA)scintigraphy.Conclusion It was determined that, as the incidence and the degreeof VUR increase, the frequency of renal scar increases; andthere is a positive correlation between VUR and renal scars.In addition, renal scintigraphy was the most sensitive ima-ging method in cases of recurrent urinary tract infections.

Keywords:

Recurrent urinary tract infections, vesicoureteral reflux, renal scar,

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