Evaluation of the renal function using 99mTc dimercaptosuccinic acid (DMSA)

Roh, Kee Seuk; Kyon, Tae Kyun; Park, Il Soon; Chang, Sae Kook

Abstract

99mTc-DMSA is a new renal scanning agent that provides a good quality of renal image as a result of preferential cortical accumulation and also makes feasible a quantitative assessment of separate kidney functions. Using 99mTc-DMSA renal scan. we evaluated renal functions in 26 patients who had unilateral non-functioning obstructed kidneys on intravenous pyelogram (IVP) and normal contralateral kidneys for recent 2 years and decided whether to perform surgeries for relief of obstructions or nephrectomies. In the patients who undertook surgeries for relief of obstructions for the recovery of renal functions, we compared renal functions of preoperative and postoperative obstructed kidneys. The results were as follows: 1. Etiologic diseases in 26 patients were urinary stones in 13. ureteropelvic junction obstructions in 7 and renal tuberculosis in 6. 2. Nephrectomies were performed in 13 patients who showed less than 15% of the total renal functions as determined by a preoperative 99mTc-DMSA scans. 3. Surgeries for relief of obstructions were performed in the other 13 patients for the recovery of the renal functions. The functions of the obstructed kidneys as determined by preoperative 99m Tc-DMSA scans were from 23% to 42% (mean 29.3%) and by postoperative 99mTc-DMSA scans were from 24% to 47 % (mean 34.4 %). The functions of the obstructed kidneys were recovered from 1% to 12% (mean 43.5 %) after surgeries for relief of obstructions. The follow-up periods were from 1 to 13 months (mean 6.6 month).