{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:30:29Z","timestamp":1790602229177,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,11,17]],"date-time":"2016-11-17T00:00:00Z","timestamp":1479340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>This study evaluated the controversial relationship between the duration of fever before treatment initiation (<jats:styled-content style=\"fixed-case\">FBT<\/jats:styled-content>) for a febrile urinary tract infection (<jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>), with renal scarring based on dimercaptosuccinic acid scintigraphy (<jats:styled-content style=\"fixed-case\">DMSA<\/jats:styled-content>) findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The inpatient records of 148 children under two years of age with a first episode of febrile <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> were analysed. Acute and repeat <jats:styled-content style=\"fixed-case\">DMSA<\/jats:styled-content> findings, and clinical and laboratory parameters were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Acute <jats:styled-content style=\"fixed-case\">DMSA<\/jats:styled-content> showed that 76 of the 148 children with a febrile <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content> had renal lesions: 20 were mild, and 56 were moderate or severe. Repeat <jats:styled-content style=\"fixed-case\">DMSA<\/jats:styled-content> showed renal scarring in 34 patients. The only factors associated with the development of renal scars in the repeat <jats:styled-content style=\"fixed-case\">DMSA<\/jats:styled-content> were <jats:styled-content style=\"fixed-case\">FBT<\/jats:styled-content> of more than 72 hours, the presence and severity of vesicoureteral reflux and increased procalcitonin levels and absolute neutrophil counts. Multiple regression analysis showed that an <jats:styled-content style=\"fixed-case\">FBT<\/jats:styled-content> above 72 hours was the only significant factor that predicted renal scars.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Delay in treatment initiation of 72 hours or more was a risk factor for permanent renal scars after the first episode of febrile <jats:styled-content style=\"fixed-case\">UTI<\/jats:styled-content>. Other associated factors were increased procalcitonin and absolute neutrophil count on admission and the presence and severity of vesicouretal reflux.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.13636","type":"journal-article","created":{"date-parts":[[2016,10,17]],"date-time":"2016-10-17T09:18:56Z","timestamp":1476695936000},"page":"149-154","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Delayed treatment of the first febrile urinary tract infection in early childhood increased the risk of renal scarring"],"prefix":"10.1111","volume":"106","author":[{"given":"Kyriaki A.","family":"Karavanaki","sequence":"first","affiliation":[{"name":"Second Department of Pediatrics National and Kapodistrian University of Athens, \u201cP. and A. 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