Child Kidney Dis.
2016 Oct;20(2):63-68. 10.3339/jkspn.2016.20.2.63.
Clinical Significance of Uptake Difference on DMSA Scintigraphy in Pediatric Urinary Tract Infection
- Affiliations
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- 1Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea. guroped@korea.ac.kr
- 2Department of Pediatrics, Korea University Ansan Hospital, Gyeonggido, Korea.
- KMID: 2366598
- DOI: http://doi.org/10.3339/jkspn.2016.20.2.63
Abstract
- PURPOSE
Disruption of normal renal development can lead to congenital anomalies of the kidney and urinary tract, including renal hypodysplasia. We aimed to clarify whether small kidney size affects clinical manifestations in children with urinary tract infection (UTI).
METHODS
One hundred fifty-four patients who had their first symptomatic UTI between January 2014 and June 2015 were enrolled in this study. Differences in kidney size were estimated based on percent uptake of (99m)Tc-dimercaptosuccinic acid (DMSA) in scintigraphy. The patients who showed more than 10% difference in kidney size on DMSA scintigraphy with none or minimal cortical defects were included in group A. (group A, n=17). Laboratory, clinical, and imaging results were compared with those of the other patients (group B, n=137).
RESULTS
Group A had a relatively higher incidence of vesicoureteral reflux than group B (44% vs 20%, P<0.05). The levels of plasma neutrophil gelatinase-associated lipocalin (NGAL) and serum C-reactive protein were significantly higher in group A (193 [64-337] vs 91 [59-211] ng/mL and 4.1 [0.5-11.9] vs 2.1 [0.7-5.3] ng/mL, respectively; all P<0.05). Linear regression analysis revealed that plasma NGAL level strongly correlated with the difference in renal uptake in DMSA scintigraphy in group A (R²=0.505).
CONCLUSION
The difference in kidney size could influence the clinical course and severity of pediatric UTI.
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