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Acta Paediatr. 2015 Nov;104(11):e512-7. doi: 10.1111/apa.13129.

Guidelines for urinary tract infections and antenatal hydronephrosis should be gender specific.

Author information

1
Department of Paediatrics, Meir Medical Centre, Kfar Saba, Israel.
2
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
3
Department of Paediatrics, Assaf Harofeh Medical Centre, Zerifin, Israel.
4
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Abstract

AIM:

Febrile urinary tract infections (UTIs) may be associated with long-term renal damage. Our goal was to identify risk factors for future UTIs in children who had voiding cystourethrography (VCUG) as a part of an antenatal hydronephrosis (ANH) assessment or after a febrile UTI.

METHODS:

We conducted a cohort study based on the medical records of children aged 0-24 months who underwent a VCUG between January 2004 and December 2011 and had at least six months of follow-up. The incidence of future UTIs was assessed.

RESULTS:

We included 285 children: 176 had a primary UTI and 109 had ANH. We recorded 28 UTIs during the follow-up period, and the risk was 12.5% after a primary UTI and 5.5% after an ANH (p = 0.049). Multivariate analysis showed no risk difference was found between the groups. Females had a greater risk of febrile UTIs (hazard ratio 3.3, 95% confidence interval 1.03-9.2, p = 0.04), but the UTI risk did not differ between children with or without VURs.

CONCLUSION:

Female infants were at greater risk of febrile UTIs, regardless of the presence of VUR, VUR degree, ANH or a previous UTI. Clinical guidelines for UTI and ANH assessment should preferably be gender specific.

KEYWORDS:

Antenatal hydronephrosis; Renal scaring; Urinary tract infection; Vesicoureteral reflux; Voiding cystourethrography

PMID:
26173376
DOI:
10.1111/apa.13129
[Indexed for MEDLINE]
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