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

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

• Lee SY
• Lim SH
• Lee DY

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.

Keyword

Urinary tract infection; Vesicoureteral reflux; Renal scar; 99mTechnetium-dimercaptosuccinic acid renal scan

MeSH Terms

Acute-Phase Proteins
Child
Cicatrix*
Diagnosis
Follow-Up Studies
Humans
Hypertension
Jeollabuk-do
Pediatrics
Pyelonephritis
Renal Insufficiency
Retrospective Studies
Succimer
Urinary Tract
Urinary Tract Infections
Vesico-Ureteral Reflux*
Acute-Phase Proteins
Succimer