ESPN 51th Annual Meeting

ESPN 2018


 
Ultrasonography findings of echogenic material in the bladder of a pediatric cohort
MARIA ISABEL LUIS YANEZ 1 ANTONIO LOPEZ FIGUEROA 2 PEDRO ARANGO SANCHO 3 PATRICIA TEJERA CARREñO 1 MARGARITA MONGE ZAMORANO 4 DESIREE ARACIL HERNANDEZ 1 ALEJANDRA PEREZ RODRIGUEZ 1 VICTOR MANUEL GARCIA NIETO 1

1- SECCION DE NEFROLOGIA PEDIATRICA DEL HOSPITAL UNIVERSITARIO NUESTRA SEñORA DE CANDELARIA, SANTA CRUZ DE TENERIFE
2- SERVICIO DE RADIOLOGIA DEL HOSPITAL UNIVERSITARIO NUESTRA SEñORA DE CANDELARIA, SANTA CRUZ DE TENERIFE
3- UNIDAD DE NEFROLOGIA PEDIATRICA DEL HOSPITAL SANT JOAN DE DEU, BARCELONA
4- CENTRO DE SALUD DE TACORONTE, TENERIFE
 
Introduction:

The coincidental finding of echogenic material in the bladder ultrasonography (EMBU) is relatively frequent in the daily practice of pediatric radiology. Nowadays, there is evidence regarding the relationship between this finding and the presence of kidney or urological abnormalities. The aim of this paper is to study the possible relation between EMBU and the alterations observed in the urinary sediment and the metabolic abnormalities that cause renal lithiasis (pre-lithiasis).

Material and methods:

A prospective study in which 62 patients were included (30M,32F) referred by a radiologist when they had an ultrasonography with EMBU. The mean age was 7.9±4.5 years (range:0.3-21.9). All were asymptomatic. On the same day of the sonography finding, urinary sediment and a culture were collected. Calcium, citrate and creatinine concentrations were analyzed in two samples (night and morning). There was a high lithogenic risk when the ratio calcium/creatinine was higher than 0.33. The history of urological abnormalities in first and second-grade relatives was recorded.

Results:

No patient had lithiasis in ultrasonography. The urinary sediment was altered in one-third of the patients (21/62;33.9%): asymptomatic bacteriuria (8/62),crystalluria (7/62),sterile leukocyturia (5/62) and microhematuria (1/62). In 20/52 (38.5%) cases, there was a lithogenic risk in the first-morning urine sample; eleven had normal sediment. The night urine sample showed less lithogenic risk (12.8%). In total, 51.6% of children (32/62) had a pathological urinary sediment and/or biochemical parameters for pre-lithiasis. There was kidney or urological abnormalities history in the families of 44/62 patients (70.9%):13 in first-grade relatives,19 in second-grade, and 12 in both generations; renal lithiasis was the most frequent family history (25/62;40.3%). In 14 of 20 cases who had lithogenic risk, family history of urolithiasis was proved (70%).

Conclusions:

The ultrasonography finding of EMBU must promote the practice of a basic urine analysis.  Half of the patients had pre-lithiasis (also with normal sediment),asymptomatic bacteriuria or sterile leukocyturia.