Project 461400

Urinary tract infection (UTI) is one of the most common and costly reasons why children are hospitalized. Based on limited evidence, current clinical practice guidelines recommend a screening kidney ultrasound in all children under 2 years of age after their first UTI. This ultrasound is recommended to identify urinary tract abnormalities present from birth that may predispose children to UTIs, long-term kidney problems, and plan further management. However, serious urinary tract abnormalities are already detected by routine ultrasounds that mothers receive while pregnant, so there is low chance that the screening kidney ultrasound will detect anything serious. While this ultrasound is non-invasive, it can lead to potential harms by detecting an abnormality that does not impact the child's health (overdiagnosis), resulting in more tests (cascade effect) and unnecessary stress for parents. Therefore, we will conduct a study across 16 Canadian hospitals, enroll young children hospitalized with their first UTI, and follow them for one year to determine the usefulness of a screening kidney ultrasound. We will collect data on the ultrasound results, all tests and treatments, whether children develop another UTI, and ask parents their experiences. Results from this study will inform healthcare professionals and parents of the best way to use kidney ultrasound to benefit Canadian children, and reduce the harm of overdiagnosis and waste of Canada's healthcare resources.