99mTc dimercaptosuccinic acid (DMSA) scan in patients with established radiological renal scarring.

Urinary tract infections (UTIs) are the most common source of bacterial infections among young febrile children. Accurate diagnosis of acute pyelonephritis (APN) and vesicoureteral reflux (VUR) is important because of their association with renal scarring, leading in the cases to long-term complications. However, the gold standard examinations for both are either DMSA scan (for APN and scar) or cystography (for VUR) and present limitations (feasibility, pain, cost, etc.). Procalcitonin, a reliable marker of bacterial infections, was demonstrated to be a good predictor of both renal parenchymal involvement in the acute phase and late renal scars. Furthermore, it was also found to be associated with high-grade VUR and was the key tool of a clinical decision rule to predict high-grade VUR in children with a first UTI. Therefore, procalcitonin may certainly be found playing a role in the complex and still debated picture of which examination should be performed after UTI in children.

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Study of DMSA (99mTc-dimercaptosuccinic acid) scan disorders in children 1-12 years with first acute pyelonephritis and its association with vesicoureteral reflux

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20180590 ◽

2018 ◽

Vol 6 (3) ◽

pp. 751

Author(s):

Majid Vafaie ◽

Javad Zare-noghabi ◽

Hadiseh Bahri

Keyword(s):

Vesicoureteral Reflux ◽

Acute Pyelonephritis ◽

Renal Scarring ◽

High Sensitivity ◽

Cross Sectional ◽

Significant Difference ◽

Febrile Uti ◽

Dimercaptosuccinic Acid Scan ◽

Dmsa Scan ◽

Negative Urine Culture

Background: Acute pyelonephritis and vesicoureteral reflux are one of the main causes of renal scarring in children, which can lead to serious complications such as hypertension and chronic renal failure. The aim of this study was to evaluate the scan disorders in children aged 1-12 years with acute pyelonephritis and its relation with ureteral bladder reflux.Methods: This retrospective cross-sectional descriptive study was conducted on all patients who had been diagnosed with febrile UTI for 4 years (2012-2015) in Ardebil's Children's Hospital. Information about 99mTc-DMSA scan and ultrasonography and cystoyurethrography of patients were extracted from the files and then analyzed by statistical methods inSPSS.19.Results: 148 children (9 boys and 139 girls) with a range of 1 to 12 years old (mean age of 52.34±4.34 months) were included in the study. Of these, 123 patients were subjected to cystoyurethrography after a negative urine culture. A 99mTc-DMSA scan report in the acute phase of the disease was abnormal in 80.4% of the children. VCUG and RNC tests were performed in 123 patients, in 70 (57%) normal cases, and in 53 cases (43%) of urinary reflux. The incidence of reflux with abnormal 99mTc-DMSA scan was 42%. There was no significant correlation between the prevalence of reflux in patients with abnormal 99mTc-DMSA scan in two groups of 1-4 years old and more than 4 years old. No significant difference was found in patients with abnormal scan in responding to treatment and comparing fever after admission in patients with normal 99mTc-DMSA.Conclusions: The results indicate high prevalence of reflux in patients with acute pyelonephritis. Due to the high sensitivity of the scan to detect pyelonephritis and, Pyelonephritis.

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New renal scarring in children who at age 3 and 4 years had had normal scans with dimercaptosuccinic acid: follow up study

BMJ ◽

10.1136/bmj.315.7113.905 ◽

1997 ◽

Vol 315 (7113) ◽

pp. 905-908 ◽

Cited By ~ 74

Author(s):

S. J Vernon ◽

M. G Coulthard ◽

H. J Lambert ◽

M. J Keir ◽

J. N S Matthews

Keyword(s):

Renal Scarring ◽

Dimercaptosuccinic Acid ◽

Follow Up Study

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A study to determine risk factors for renal scarring as detected by dimercaptosuccinic acid scan in children with urinary tract infection

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20212764 ◽

2021 ◽

Author(s):

Nisha Jacob Arackal Jacob ◽

Seshagiri Koripadu ◽

Harishchandra Venkata Yanamandala

Keyword(s):

Risk Factors ◽

Urinary Tract Infection ◽

Renal Scarring ◽

Significant Risk ◽

Significant Risk Factor ◽

Positive Group ◽

Recurrent Uti ◽

Significant Difference ◽

Dimercaptosuccinic Acid Scan ◽

Dmsa Scan

Background: The aim of the study was to determine the risk factors for renal scarring detected by DMSA (dimercaptosuccinic acid) scan in children with culture-proven urinary tract infection (UTI).Methods: A hospital based observational case-control study was conducted from 2018 June to 2020 June in children aged between 1 month to 5 years who underwent a DMSA scan following culture-proven UTI (N=72). Of the children fulfilling the criteria, 43 had renal scarring in the DMSA scan as a case group and the remaining 29 children who had no renal scarring were taken as a control group.Results: Of the total 72 cases with culture-positive UTI, 59% of patients had renal scarring and the rest and 40% were scar negative. There was no significant difference in the renal scarring observed with respect to age in the two groups. There was significant (p<0.05) the association noted between renal scarring and VUR (vesicoureteric reflux). A significant difference was observed in the renal scarring between the two groups regarding the presence of recurrent UTI (p=0.000). Although most cases (97.7%) had a fever in the DMSA positive group, this was not a significant risk factor for scarring (p>0.05). In DMSA positive group, circumcision was not a significant risk factor for scarring.Conclusions: VUR and recurrent UTI were significant risk factors for renal scarring in children with culture-proven UTI as detected by DMSA scan. The other risk factors like age, sex, fever, leucocytosis and circumcision were not found to be significant.

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