Kidney ultrasound detects urinary tract abnormality in 25 percent Children with first febrile UTI

Written By :  Dr. Shravani Dali
Medically Reviewed By :  Dr. Kamal Kant Kohli
Published On 2023-06-05 14:30 GMT   |   Update On 2023-06-06 07:00 GMT
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Kidney ultrasound detects urinary tract abnormality in 25 percent Children with first febrile UTI suggests a new study published in the JAMA Pediatrics

Controversy exists on the clinical utility of kidney ultrasonography after first febrile urinary tract infection (UTI), and clinical practice guideline recommendations vary. A study was done to determine the prevalence of urinary tract abnormalities detected on kidney ultrasonography after the first febrile UTI in children.

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The MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Central Register of Controlled Trials databases were searched for articles published from January 1, 2000, to September 20, 2022.
Studies of children with first febrile UTI reporting kidney ultrasonography findings. Two reviewers independently screened titles, abstracts, and full texts for eligibility. Study characteristics and outcomes were extracted from each article. Data on the prevalence of kidney ultrasonography abnormalities were pooled using a random-effects model.
The primary outcome was prevalence of urinary tract abnormalities and clinically important abnormalities (those that changed clinical management) detected on kidney ultrasonography. Secondary outcomes included the urinary tract abnormalities detected, surgical intervention, health care utilization, and parent-reported outcomes.
Results

Twenty-nine studies were included, with a total of 9170 children. Of the 27 studies that reported participant sex, the median percentage of males was 60%

The prevalence of abnormalities detected on renal ultrasonography was 22.1% and 21.9% The prevalence of clinically important abnormalities was 3.1% and 4.5%

Study recruitment bias was associated with a higher prevalence of abnormalities.

The most common findings detected were hydronephrosis, pelviectasis, and dilated ureter. Urinary tract obstruction was identified in 0.4%, and surgical intervention occurred in 1.4% One study reported health care utilization. No study reported parent-reported outcomes.

Results suggest that 1 in 4 to 5 children with first febrile UTI will have a urinary tract abnormality detected on kidney ultrasonography and 1 in 32 will have an abnormality that changes clinical management. Given the considerable study heterogeneity and lack of comprehensive outcome measurement, well-designed prospective longitudinal studies are needed to fully evaluate the clinical utility of kidney ultrasonography after first febrile UTI.
Reference:

Yang S, Gill PJ, Anwar MR, et al. Kidney Ultrasonography After First Febrile Urinary Tract Infection in Children: A Systematic Review and Meta-analysis. JAMA Pediatr. Published online May 30, 2023. doi:10.1001/jamapediatrics.2023.1387

Keywords:

Kidney, ultrasound, detects, urinary, tract, abnormality, 25 percent, Children, first, febrile, UTI, Yang S, Gill PJ, Anwar MR,JAMA Pediatrics

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Article Source : JAMA Pediatrics

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