Initial 99mTechnetium-dimercaptosuccinic Acid (DMSA) Renal Scan Finding and Vesicoureteral Reflux as Predicting Factor of Renal Scarring

Lee, Soo-Yeon; Lim, So-Hee; Lee, Dae-Yeol

J Korean Soc Pediatr Nephrol > Volume 7(1); 2003 > Article

J Korean Soc Pediatr Nephrol 2003;7(1): 44-51.

신반흔 예측인자로서 초기 99mTechnetium-dimercaptosuccinic Acid 신주사 소견과 방광요관 역류의 유무 및 정도

이수연, 임소희, 이대열

¹전북대학교 의과대학 소아과학교실
²전북대학교 의과대학 소아과학교실
³임상의학연구소

Initial 99mTechnetium-dimercaptosuccinic Acid (DMSA) Renal Scan Finding and Vesicoureteral Reflux as Predicting Factor of Renal Scarring

Soo-Yeon Lee, So-Hee Lim, Dae-Yeol Lee

¹Department of Pediatrics, Chonbuk National University College of Medicine
²Department of Pediatrics, Chonbuk National University College of Medicine
³Research Institute of Clinical Medicine

ABSTRACT

Purpose : Acute pyelonephritis in children may result in permanant renal damage which later in life may lead to hypertension and renal failure. The purpose of this study was to evaluate the factors that might be useful for predicting the development of renal scar in children with urinary tract infection(UTI).
Methods : We retrospectively reviewed 442 patients with UTI who were admitted to the Department of Pediatrics of Chonbuk National University Hospital, during the period from April 1992 to March 2002. The patients were divided into two groups according to the presence of renal scar on the follow-up DMSA renal scan, and we compared the factors associated with renal scarring between the two groups.
Results : There were no significant differences in sex, causative organism and acute phase reactants between the groups with and without renal scar. The age at diagnosis was significantly higher in the renal scar group compared to that without scar. Of the 60 patients with renal scar, 78% had vesicoureteral reflux(VUR), but 13% of patients without scar had VUR. Furthermore, the severity of VUR was significantly correlated with renal scar formation. 53% showed multiple cortical defects on the initial DMSA renal scan, compared to 32% in the non-scar group. In addition, 76% of patients showing multiple cortical defects on the initial DMSA renal scan with VUR had renal scar.
Conclusion : The presence and grade of VUR, and findings on the initial DMSA renal scan would contribute to predict risk of renal scar formation in children with UTI.

Key words: Urinary tract infection | Vesicoureteral reflux | Renal scar | $^{99m}Technetium-dimercaptosuccinic\ | acid\ | renal\ | scan$