Abstract
Tests are needed to identify children with urinary infection (UTI) who are at high risk for having VUR and other treatable abnormalities. To identify risk factors, we studied 40 children <13 years old who had UTI. History of previous UTI, race, age, temperature, C-reactive protein (CRP) and renal concentrating ability after intranasal administration of 1-deamino-8-Darginine vasopressin (DDAVP) were evaluated as predictors of abnormalities. IVP, voiding cystogram and renal ultrasound were done in all patients. VUR was present in 7/40 (18%) and was the only treatable abnormality found. Results: The proportion of subjects with VUR were: Race: White 7/32 (22%); Black 0/8. Age: <5 yrs. 7/26 (27%); ≥5 yrs. 0/14. Fever: ≥ 38C, 6/14 (43%); <38C, 1/26 (4%). Six of ten White children <5 yrs. who were febrile had VUR; only 4% (1/25) of children not in this group had VUR (p=0.0007). History of a prior UTI was not of predictive value. Laboratory tests and the proportion of subjects with VUR were: CRP: >10 mg/dl, 5/14 (36%); ≤10mg/dl, 1/19 (5%) (p=0.036). Maximum urine osmolality with DDAVP: <800 mosm 5/14 (35%), ≥800 mosm 1/12 (8%) (p=0.117). Conclusions: Race, age and presence of fever identify the majority of children with VUR. CRP and the DDAVP test may be of additional value in identifying high-risk children.
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Johnson, C., Marchant, C., Shurtn, P. et al. CLINICAL AND LABORATORY INDICATORS OF VESICOURETERAL REFLUX (VUR). Pediatr Res 18 (Suppl 4), 363 (1984). https://doi.org/10.1203/00006450-198404001-01621
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DOI: https://doi.org/10.1203/00006450-198404001-01621