Urinary tract abnormalities in children with first urinary tract infection

Abstract

Background: Pediatric urinary tract infections (UTIs) are a major health-care issue. UTI may be a harbinger of variety of underlying urinary tract abnormalities. The long-term complications of recurrent UTI are kidney scarring, hypertension, and chronic kidney disease. Aim: The present study aims to determine the prevalence of urinary tract abnormalities in children with first episode of UTI. Materials and Methods: This study was a hospital-based prospective observational study carried out in the department of pediatrics over a period of 15 months from January 2015 to March 2016. A total of 100 children with culture-positive first UTI who fulfilled the inclusion criteria were enrolled in the study. Ultrasonography (USG) abdomen, micturating cystourethrography (MCU), and dimercaptosuccinic acid (DMSA) kidney scan were done. Results: Among 100 children with culture-proven UTI, USG was abnormal in 16% with the majority (31.7%) having hydroureteronephrosis. MCU was abnormal in 14% and DMSA in 13%. About 9% had kidney scarring. Overall prevalence of urinary tract abnormalities was 14%. About 42.8% of urinary tract abnormalities were detected in children between 1 and 5 years and 35.7% below 1 year. Vesicoureteral reflux was the most common abnormality (8.0%). Conclusion: UTI in young children serves as marker for abnormalities of the urinary tract. Early diagnosis is of considerable significance to preserve kidney function and prevent complications.