Relative renal functions for children using 99mTC-DTPA and 99mTC-DMSA

Radionuclides are widely used to study the relative renal functions (RRFs) for kidney patients. This work reports the determination of the RRFs using the technetium-99m dimercaptosuccinic acid (99mTc-DMSA) and technetium-99m diethylenetriamine-pentaacetic acid (99mTc-DTPA) for children having kidney diseases. The two methods are then compared to find the choice of scintigraphy for a particular type of disease. A total of 65 child kidney patients of ages 5 months - 16 years were the representative samples of the study. The mean RRFs calculated with 99mTc-DTPA was found as and respectively, for the left and right kidneys. On the other hand, the values are and respectively, using 99mTc-DMSA. a significant positive correlation () were found between the RRFs calculated with the two scanning methods in Pearson correlation analysis. In one way ANOVA test, we did not find any difference between the RRFs calculated with 99mTc-DTPA and 99mTc-DMSA between the left and right kidneys. In Bland-Altman Plots, no mean difference was found between the two scanning methods and the correlation limit lies between -13.5 and12.6. The present study suggests using a single method for a particular type of disease. 99mTc-DMSA is the primary choice for the evaluation of RRF since it is easy, inexpensive and also provides cortical morphology, renal scar and cyst evaluation. But for glomerular filtration rate and renogram curve, 99mTc-DTPA should be the obvious selection as 99mTc-DMSA fails to provide any information for these cases. Journal of Bangladesh Academy of Sciences, Vol. 44, No. 2, 109-119, 2020

Could Pyelonephritic Scarring Be Prevented by Anti-Inflammatory Treatment? An Experimental Model of Acute Pyelonephritis

Objectives.This study aimed to demonstrate if the addition of anti-inflammatory treatment to antibiotic therapy shows any superiority to the treatment with antibiotic only.Methods.Forty-nine Wistar rats were divided into 7 groups. Pyelonephritis was performed byE. coliinjection to upper pole of kidneys except control group. Group 2 was not treated. Ceftriaxone, ketoprofen, “ceftriaxone + ketoprofen,” methylprednisolone, and “ceftriaxone + methylprednisolone” were given in the groups. The technetium-99m-dimercaptosuccinic acid scintigraphies were performed in 3rd day to detect pyelonephritis and 10th week to detect renal scarring. All kidneys were also histopathologically evaluated.Results.When 3rd day and 10th week scintigraphies were compared, initial 2.00 ± 0.30 point pyelonephritis score resulted in 0.71 ± 0.36 renal scar score in “ceftriaxone + ketoprofen” group (P=0.039). Initial 2.00 ± 0.43 point pyelonephritis score resulted in 0.86 ± 0.26 renal scar score in “ceftriaxone + methylprednisolone” group (P=0.041). Renal scar score was declined in “ceftriaxone + ketoprofen” group and “ceftriaxone + methylprednisolone” group compared with no-treatment group on 10th week of the study (P=0.026,P=0.044). On histopathological evaluation, it was seen that renal scar prevalence and expansion declined significantly in “ceftriaxone + ketoprofen and ceftriaxone + methylprednisolone” (P=0.011,P=0.023).Conclusion.It was evidenced that ceftriaxone treatment in combination with ketoprofen or methylprednisolone declined scar formation in scintigraphic and histopathologic examinations of the kidneys.

Assessment of the Effects of Access Count in Percutaneous Nephrolithotomy on Renal Functions by Technetium-99m-Dimercaptosuccinic Acid Scintigraphy

Objective. To determine the effects of percutaneous nephrolithotomy on renal functions by using DMSA scintigraphy while considering access counts. Material and Methods. A total of 37 patients who had undergone percutaneous nephrolithotomy were included. Preoperative DMSA scans were performed a day before the surgery, whereas postoperative scans were randomized by evaluating them before () and after () the 6th postoperative month. Twenty-six of 37 cases underwent percutaneous nephrolithotomy with a single access site and 11 with multiple access sites. Results. There were no significant changes of total renal functions in the whole study group (). In the single access group, total functions were significantly elevated () In the multiple access group, while treated site functions were significantly decreased (), total functions did not change significantly (). There was an insignificant decrease in those evaluated before the 6th postoperative month () and an insignificant increase in the others (). Conclusion. We could not find a superiority of single access over multiple accesses. There is a temporary functional loss in the treated site.