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KMID : 0811820030070010044
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Journal of Korean Society of Pediatric Nephrology
2003 Volume.7 No. 1 p.44 ~ p.51
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Initial 99mTechnetium-dimercaptosuccinic Acid(DMSA) Renal Scan Finding and Vesicoureteral Reflux as Predicting Factor of Renal Scarring
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Lim So-Hee
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Abstract
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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 phasereactants 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 mutiple 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.
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KEYWORD
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Urinary tract infection, Vesicoureteral reflux, Renal scar, 99mTechnetium-dimer-captosuccinic acid renal scan
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