Occurrence of renal scars in children after their first referral for urinary tract infection

Urinary tract infections in childhood may cause renal scars, which can lead to hypertension and renal failure: diagnostic imaging is therefore important to detect children with scarring so that they can be monitored. A multidisciplinary group that produced imaging guidelines1 broadly agreed that younger children should have a dimercaptosuccinic acid (DMSA) scan to detect scarring and an ultrasonography to identify structural lesions after one infection, but most thought that children over 7 years should be investigated only after recurrent infections, using ultrasound only, perhaps because of their low risk of new scar formation.2 Others have suggested imaging only children who have a fever.3 In Newcastle we have performed ultrasound and dimercaptosuccinic acid scans (after two months free of infection) on every child when first referred after a urinary tract infection. Here we describe …