Febrile Urinary Tract Infection, Vesicoureteral Reflux, and Renal Scarring: Current Controversies in Approach to Evaluation

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2011 Feb 10

PMID 21305381

Citations 12

Authors

Martin A Koyle

Jack S Elder

Steven J Skoog

Tej K Mattoo

Hans G Pohl

Pramod P Reddy

Jennifer M Abidari

Warren T Snodgrass

Affiliations

Soon will be listed here.

Abstract

The ideal approach to the radiological evaluation of children with urinary tract infection (UTI) is in a state of confusion. The conventional bottom-up approach, with its focus on the detection of upper and lower urinary tract abnormalities, including vesicoureteral reflux, has been challenged by the top-down approach, which focuses on confirming the diagnosis of acute pyelonephritis before more invasive imaging is considered. Controversies abound regarding which approach may best assess the ultimate risk for reflux-related renal scarring. Evolving practices motivated by the emerging evidence, the desire to minimize unnecessary interventions, as well as improve compliance with recommended testing, have added to the current controversies. Recent guideline updates and ongoing clinical trials hopefully will help in addressing some of these concerns.

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