The purpose of this study is to determine the predictive value of renal ultrasonography (USG) and 99m technetium dimercaptosuccinic acid renal scintigraphy (DMSA) in the prediction of vesicoureteral reflux (VUR) after the first febrile urinary tract infection (UTI) in children compared to the voiding cystourethrography (VCUG). The medical records of 332 patients (83.1 % girls and 16.9% boys), who were followed up at the Department of Pediatric Nephrology for the first febrile urinary tract infection between 2008 and 2013, whose USG, VCUG, and DMSA imaging techniques were performed within 6 months, were retrospectively analyzed. The mean age was 63.4 months (±43.3). VUR was shown in 167 (50.3%) of 332 children; 93 (56%) were unilateral, and 74 (44%) were bilateral. According to renal units, VUR was detected in 241 of 664 (36.3%) renal units; 151 (22.7%) were mild (grade I-III), and 90 (13.6%) were severe (grade IV-V). Abnormal USG and DMSA findings were found in 293 (44.1%) and 256 (38.6%) of 664 kidney units, respectively. Both abnormal USG findings and renal scar formation in DMSA were associated with reflux severity (p = 0.001). The sensitivity and negative predictive values of USG and DMSA were 68.9 and 67.8; 92.5 and 92.9 respectively. In conclusion, in patients with the first UTI, normal USG, and DMSA have high negative predictive values on reflux. Normal urinary USG and DMSA scan results diminish the need for VCUG.

Keywords: urinary tract infections, vesicoureteral reflux, ultrasonography, renal scintigraphy