Pediatric Renal Abscess: A 12-year Single-Center Retrospective Analysis

Background Renal abscesses are infrequent but serious consequences of urinary tract infections in children, frequently manifesting with nonspecific symptoms that might postpone diagnosis. Research on pediatric renal abscesses is limited. Methods This retrospective study investigated 69 children with radiologically verified renal abscesses from November 2012 to February 2024. Patients were categorized into three age groups: 1–24 months, 25–60 months, and over 60 months. Clinical features, laboratory and imaging results, and therapy outcomes were assessed. Results The median age was 24.0 months (IQR: 7.3, 66.8) and the male-to-female ratio of 35:34. Age-stratified analysis revealed a male predominance in the 1–24-month group (26 males vs. 9 females) and a female predominance in the > 60-month group (17 females vs. 2 males). Fever was noted in 98.6% (68/69), abdominal pain in 29.0% (20/69) and gastrointestinal symptoms in 26.1% (18/69). Ultrasound identified enlarged kidneys in 52.2% (36/69) of cases. The sensitivity of renal ultrasound was 40.4% (61/151). Vesicoureteral reflux was observed in 52.6% (20/38) of cases. Urine cultures demonstrated positive results in 34.8% (24/69) of cases, with Escherichia coli (37.5%, 9/24) and Enterococcus species (25.0%, 6/24) identified as the predominant pathogens. Surgical intervention was required in 7.2% (5/69) of cases, and 7.2% (5/69) developed acute kidney injury. The median duration of hospital stay was 12.0 days (IQR: 9.0, 15.0), with an extension observed in cases of left-sided or bilateral involvement (adjusted P = 0.0315, 0.0327). Conclusion This study highlights the diagnostic importance of enhanced CT/MRI and the significance role of vesicoureteral reflux in pediatric renal abscesses.