Tekrarlayan idrar yolu enfeksiyonu bulunan çocuklarda görüntüleme yöntemleriyle saptanan üriner sistem patolojileri sıklığı
Yükleniyor...
Tarih
2001
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Türkiye Klinikleri
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Amaç: İdrar yolu enfeksiyonu ile birlikte bulunabilen vezikoüreteral reflü (VUR) ve renal skarlaşmanın araştırılması ileride gelişebilecek hipertansiyon ve böbrek yetmezliğinin önlenmesi bakımından önemlidir. Çocuklarda üriner sistem görüntülemesinde kullanılan ultrasonografi (US), miksiyon sistoüretrografi (MSUG) ve dimerkaptosüksinik asid sintigrafisi (DMSA) ile ne oranda üriner patoloji saptanabildiğini göstermek amacıyla çalışma planlandı. Materyel ve Metod: Çalışmaya 1994-1999 yılları arasında tekrarlayan idrar yolu enfeksiyonu (t-iye) tanısıyla izlenen, yaş ortalaması 5.0±3.7 yıl (4 ay-16 yıl arası) olan, 98i (%81) kız, toplam 121 çocuk alındı. Hastaların tümüne US, DMSA ve VSUG; 46sına (%38.0) intravenöz piyelografi (IVP) uygulandı. Bulgular: Çocukların 37sinde (%30.6) USde anormallik, 43ünde (%35.5) DMSAda renal skar, 33ünde (%27.2) MSUGde VUR saptandı. VUR saptanan çocuklarda %60.6 (20/33) oranında renal skar gözlenirken, VUR bulunmayanlarda %26.1 (23/88) oranında skar saptandı (p<0.001). Renal skar saptanan çocuklarda VUR sıklığı %46.5 iken, skar bulunmayan çocuklarda VUR sıklığı %16.7 idi (p<0.001). Reflü bulunan 33 hastadan 21inde, renal skarlı 43 hastadan 30unda US normal sonuç verdi. Ultrasonografinin renal skar ve VUR için sensitivitesi %30.2 ve %36.4, spesifitesi %74.3 ve %77.3 olarak bulundu. Sonuç: Tekrarlayan idrar yolu enfeksiyonlarında VUR saptananlarda renal skar, skar saptananlarda VUR daha sıktır. Yalnız başına US, t-iye izleminde renal skar ve VURu göstermede yetersiz kalmaktadır.
Purpose: The investigation of renal scarring and vesicoureteral reflux (VUR) is of paramount importance in order to prevent hypertension and chronic renal failure in children with urinary tract infection (UTI). The aim of this study was to investigate the frequency of urinary system abnormalities by various imaging methods, in children with recurrent UTI (r-UTI). Material and Methods: A total of 121 children (98 female), mean aged 5.0±3.7 years, followed-up with r-UTI between 1994-1999 years, were included. Abdominal ultrasound (US), 99mTc-dimercaptosuccinic acid renal scintigraphy (DMSA) and voiding cystourethrography (VCUG) were performed in all children, intravenous urography was performed in 46 (38.0%) of them. Results: We found renal and urinary tract abnormalities in 37 children (30.6%) by US, in 43 (35.5%) by DMSA, and in 33 (27.2%) by VCUG. Renal scarring was detected in %60.6 patients with VUR, while 26.1% of patients without VUR had renal scarring. The frequency of VUR was 46.5% and 16.7%, respectively, in children with and without renal scarring. Ultrasound showed no abnormality in 21 of 33 children with reflux and in 30 of 43 children with renal scarring. The sensitivity and specificity of US were 30.2% and 74.3% for detection of renal scarring and 36.4% and 77.3% for VUR. Conclusions: The frequency of renal scarring was higher in children with VUR and the frequency of VUR was higher in children with renal scarring. Ultrasound alone is inaccurate for the detection of renal scarring or VUR in children with r-UTI.
Purpose: The investigation of renal scarring and vesicoureteral reflux (VUR) is of paramount importance in order to prevent hypertension and chronic renal failure in children with urinary tract infection (UTI). The aim of this study was to investigate the frequency of urinary system abnormalities by various imaging methods, in children with recurrent UTI (r-UTI). Material and Methods: A total of 121 children (98 female), mean aged 5.0±3.7 years, followed-up with r-UTI between 1994-1999 years, were included. Abdominal ultrasound (US), 99mTc-dimercaptosuccinic acid renal scintigraphy (DMSA) and voiding cystourethrography (VCUG) were performed in all children, intravenous urography was performed in 46 (38.0%) of them. Results: We found renal and urinary tract abnormalities in 37 children (30.6%) by US, in 43 (35.5%) by DMSA, and in 33 (27.2%) by VCUG. Renal scarring was detected in %60.6 patients with VUR, while 26.1% of patients without VUR had renal scarring. The frequency of VUR was 46.5% and 16.7%, respectively, in children with and without renal scarring. Ultrasound showed no abnormality in 21 of 33 children with reflux and in 30 of 43 children with renal scarring. The sensitivity and specificity of US were 30.2% and 74.3% for detection of renal scarring and 36.4% and 77.3% for VUR. Conclusions: The frequency of renal scarring was higher in children with VUR and the frequency of VUR was higher in children with renal scarring. Ultrasound alone is inaccurate for the detection of renal scarring or VUR in children with r-UTI.
Açıklama
Anahtar Kelimeler
Çocuk, Görüntüleme yöntemleri, İdrar yolu enfeksiyonu, Skar, Vezikoüreteral reflü, Children, Imaging methods, Urinary tract infection, Renal scarring
Kaynak
Türkiye Klinikleri Pediatri Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
10
Sayı
1
Künye
Ece, A., Yılmaz, M. E., Gürkan, F., Bükte, Y. ve Haspolat, Y. K. (2001). Tekrarlayan idrar yolu enfeksiyonu bulunan çocuklarda görüntüleme yöntemleriyle saptanan üriner sistem patolojileri sıklığı. Türkiye Klinikleri Pediatri Dergisi, 10(1), 30-35.
