F. Arnello et al., Overall and single-kidney clearance in children with urinary tract infection and damaged kidneys, J NUCL MED, 40(1), 1999, pp. 52-55
Citations number
15
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
The overall and single-kidney clearance in children with acute urinary trac
t infection was investigated retrospectively using the combination of the r
elative Tc-99m-dimercaptosuccinic acid (DMSA) uptake and the Cr-51-ethylene
diaminetetraacetic acid clearance. Methods: There were 180 patients with bo
th normal kidneys, 56 with clear unilateral abnormalities an DMSA scintigra
phy and 11 with two abnormal kidneys. Half of the patients were younger tha
n 2 y, and because of the progressive maturation of the renal function, the
y were not considered in the analysis of the absolute overall and single-ki
dney clearance; nevertheless, they were included in the analysis of the rel
ative DMSA percentage uptake. Results: When only one kidney was affected on
DMSA scintigraphy, the clearance of the affected kidney was lower than on
the normal side and often abnormally low. In these unilaterally affected ki
dneys, contralateral compensation mechanisms tended to occur, resulting in
preservation of overall clearance. This compensation was probably not prese
nt only on the contralateral side. On the abnormal side, the clearance was
normal in about half of the cases, probably because of intrarenal compensat
ion occurring in regions not damaged by the infection. in addition to these
compensation mechanisms, hyperfiltration was probably present in many case
s of acute urinary tract infection with intact or unilaterally damaged kidn
eys.