Pediatr Nephrol. 2007;22:844-848
A fever of 38.5º C or higher may predict which children have vesicoureteral reflux (VUR), and C-reactive protein (CRP) levels above 50 mg/L may identify children with high-grade VUR, a Turkish study found.
Researchers studied 88 children with febrile UTI who underwent voiding cystoureterography. They compared children with and without VUR (group 1 and 2, respectively) and children with high-grade (III-V) and low-grade (I-II) VUR (groups 3 and 4, respectively.
Of the 88 children, 38 had VUR and 21 had high-grade VUR. The investigators noted that because most low-grade VUR is not associated with renal damage and resolves spontaneously, more attention should be directed to detecting high-grade VUR.
A fever of 38.5º C or higher was associated with a 7.5 times increased risk of VUR. It was the only variable that predicted the presence of VUR. A CRP level above 50 mg/L was associated with a 15 times increased risk of high-grade VUR; this was the only variable that distinguished children with high-grade VUR from those with no or low-grade VUR.
Performing voiding cystourethrography based on this CRP level would fail to identify 9% of patients with high-grade VUR, whereas 69% of children with no or low-grade VUR would be spared from this test, the researchers noted.