The symptom of urinary tract infection in children is non-specific and systemic compared to that of adults. So the diagnosis of UTI in children can be delayed. If UTI in children is not appropriately managed, it may be resulted in renal failure, hypertension, growth failure in adolescence because there are already documented renal scar or urinary tract abnormality in infection period. Especially upper UTI that involve renal parenchyme may be result in fatal complication. The purpose of this study is analyzing the relationship between acute reactive marker and ^99mTc-DMSA renal scan in upper urinary tract infection.

This study included 56 children admitted at Dankook University Hospital Pediatric Department in Jan. 1995 ~ May. 1998. We analyzed quantatively the results of acute reactive marker(CRP, ESR, WBC), pyuria, fever and compared to those of sonographically finding and ^99mTc-DMSA renal scan. Comparison between groups were performed by the chi-square(χ²) test and a p value of less than 0.05 was considered statistically significant.

1) The number of boys less than 1 year of age was larger than that of girls. But the number of boys more than 1 year of age was reversed.

2) The higher the level of reactive marker (CRP, WBC), the more the probability of upper UTI.

3) The higher fever, the more the probability of upper UTI.

4) The more pyuria, the more probability of upper UTI.

5) The more higher the grade of vesicoureteral reflux, the more probability of upper UTI.

6) ^99mTc-DMSA renal scan is more sensitive and more specific diagnostic tool than renal sonogram .

he appearance of an abnormal ^99mTc-DMSA renal scan is correlated with acute reactive marker (CRP, ESR, WBC), fever, pyuria. ^99mTc-DMSA renal scan can be a good valuable predictor tool in upper UTI. So we can start early treatment and decrease the incidence of complication of upper urinary tract by above indicators before knowing the result of urine culture. And we can follow up the patients in more good relationships with their parents by telling them the duration of treatment and follow-up plan.