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Demographic, Clinical, and Laboratory Factors Associated With Renal Parenchymal Injury in Iranian Children With Acute Pyelonephritis Publisher Pubmed



Fahimi D1 ; Khedmat L2 ; Afshin A3 ; Jafari M4 ; Bakouei Z5 ; Beigi EH6 ; Kajiyazdi M7 ; Izadi A4 ; Mojtahedi SY3
Authors
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Authors Affiliations
  1. 1. Children’s Hospital Medical Centre, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
  3. 3. Department of Pediatric Nephrology, Bahrami Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Pediatric Infection Disease, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Pediatric Intensive Care Unit, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Department of Pediatric Hematology and Oncology, Tehran University of Medical Sciences, Tehran, Iran

Source: BMC Infectious Diseases Published:2021


Abstract

Background: The association between renal parenchyma changes on dimercaptosuccinic acid (DMSA) scans and demographic, clinical, and laboratory markers was assessed in pediatric patients with acute pyelonephritis. Methods: A retrospective study of 67 Iranian babies and children aged 1-month to 12-year with APN was conducted between 2012 and 2018. The presence of renal parenchymal involvement (RPI) during APN was determined using technetium-99m DMSA during the first 2 weeks of hospitalization. The association of DMSA results with demographic data, clinical features (hospitalization stay, fever temperature and duration), and laboratory parameters such as pathogen type, and hematological factors (ESR, CRP, BUN, Cr, Hb, and WBC) was evaluated. Results: 92.5% of children with an average age of 43.76 ± 5.2 months were girls. Twenty-four children (35.8%) did not have renal parenchymal injury (RPI), while 26 (38.8%) and 17 (25.4%) patients showed RPI in one and both kidneys, respectively. There was no significant association between RPI and mean ESR, CRP, BUN, and WBC. However, there were significant associations between RPI and higher mean levels of Cr, Hb, and BMI. Conclusions: Low BMI and Hb levels and increased Cr levels might be indicative of the presence of RPI in children with APN. © 2021, The Author(s).