Differences in the Clinical Characteristics of Children with Urinary Tract Infections Based on the Results of 99mTc-Dimercaptosuccinic Acid Renal Scanning.
- Author:
Dong Ouk KIM
1
;
Sang Min LEE
;
Jeong Bong LEE
;
Young Bin KO
;
Su Jin KIM
Author Information
1. Department of Pediatrics, Myongji Hospital, Goyang, Korea. sjkim0128@mjh.or.kr
- Publication Type:Original Article
- Keywords:
DMSA scan;
Urinary tract infection;
Kidney ultrasonography
- MeSH:
Blood Urea Nitrogen;
C-Reactive Protein;
Child*;
Cicatrix;
Creatinine;
Diagnosis;
Fever;
Hospitalization;
Humans;
Incidence;
Kidney;
Leukocytes;
Male;
Neutrophils;
Pyelonephritis;
Retrospective Studies;
Succimer;
Technetium Tc 99m Dimercaptosuccinic Acid*;
Ultrasonography;
Urinary Tract Infections*;
Urinary Tract*;
Vesico-Ureteral Reflux
- From:Journal of the Korean Society of Pediatric Nephrology
2013;17(2):110-116
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The 99mTc-Dimercaptosuccinic acid (DMSA) renal scan is used primarily for the diagnosis of renal scarring and acute pyelonephritis in children with urinary tract infections (UTI). This study aimed to evaluate clinical differences based on the positive or negative results of DMSA scans and kidney ultrasonography (US) in pediatric UTI. METHODS: We retrospectively reviewed 142 pediatric patients with UTI who were admitted to Myongji Hospital from January 2004 to December 2012. We performed a comparative analysis of clinical parameters such as age, sex, white blood cell (WBC) count, neutrophil count, blood urea nitrogen (BUN) level, creatinine (Cr) level, C-reactive protein (CRP) level, and durations of hospitalization and fever, grouped by the results of the DMSA scans and kidney US. RESULTS: The mean age of the patients was 33.8+/-48.3 months, and 78 (55%) were male. Fifty-two patients had abnormal DMSA findings, and 71 patients had abormal kidney US findings (test positive groups). In the DMSA scan positive group, there were significant differences in age, WBC counts, neutrophil counts, CRP level, BUN level, Cr level, hospitalization duration, number of abnormal findings on kidney US, and incidence of vesicoureteral reflux (VUR) compared with the scan negative group. The kidney US positive group had significant differences in age, neutrophil count, CRP level, BUN level, Cr level, hospitalization duration, number of abnormal findings on the DMSA scans, and more frequent VUR compared with the US negative group. CONCLUSION: Our data suggest that there were no major differences in clinical parameters based on the results of the DMSA scans compared with kidney US in pediatric UTI. However, as kidney US and DMSA scan were performed to predict VUR, the sensitivity and negative predictive value was increased.
