Any Undiagnosed Vesicoureteral Reflux Following the Adoption of Thai Pediatric Nephrology Association- Endorsed Clinical Practice Guideline 2014 on Urinary Tract Infection in Children Aged 2 Months to 5 Years
Sorapipatcharoen K, MD1, Pruangprasert P, MD1
Affiliation : 1 Department of Pediatrics, HRH Princess Maha Chakri Sirindhorn Medical Center, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
Objective : To assess the diagnosis for vesicoureteral reflux (VUR) among children aged 2 months to 5 years comparing between the
Thai Pediatric Nephrology Association endorsed clinical practice guideline (CPG) 2014 and urinary tract infection (UTI) CPG 2010.
Materials and Methods : The medical records of febrile children (age 2 months to 5 years) who were admitted to the HRH Princess
Maha Chakri Sirindhorn medical center during January 2002 to December 2012 were retrospectively reviewed. The CPG 2014 and
2010 were applied and the diagnosis of VURs were assessed.
Results : A total of 71 UTI patients were included in the present study. By using the CPG 2014 and CPG 2010, VUR was detected in five
and ten patients respectively. The severity of VUR detected only by using CPG 2010 in five patients was only low-grade severity. Of
note, two patients with high grade VUR were detected by both CPGs.
Conclusion : The application of CPG 2014 was able to detect high grade VURs which might further need a surgical management. The
long term follow-up was recommended for all children with UTI due to possibly undiagnosed low-grade VUR in some cases.
Keywords : Urinary tract infection, Ultrasound, voiding cystourethrogram, High grade vesicoureteral reflux, Low grade vesicoureteral reflux, Thai pediatric guideline 2014
