Document Detail

Does severity of renal scarring on DMSA scan predict abnormalities in creatinine clearance?
MedLine Citation:
PMID:  20472269     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To examine the relationship between severity of renal scarring and creatinine clearance. Existing studies on renal scarring and functional outcomes have focused on the presence or absence of scarring. METHODS: Patients with a history of urinary tract infection leading to the diagnosis of vesicoureteral reflux were recruited. These subjects were admitted to a pediatric research center for an in-patient collection of 24-hour urine to be sent for creatinine and protein. DMSA scans performed at least 6 months after documented urinary tract infection were graded by 3 independent, blinded pediatric urologists for renal scarring according to the Randomized Intervention for Children with Vesicoureteral Reflux study criteria. RESULTS: Twenty-nine subjects (14 girls, 15 boys) with a median age of 7 years were recruited. Scar grading was reliable between the observers with a Kappa score of 0.66-0.75. On DMSA scan, 10% were scar-free, 62% had unilateral scars, and 28% had bilateral scars. Mean creatinine clearance was 123 for those with unilateral disease and 100 for those with bilateral disease (P = .048). Median proteinuria (58 mg/dL) and serum creatinine (0.5 mg/dL) were similar between the 2 groups. Creatinine clearance did not differ according to average scar grade, taking both kidneys into account. CONCLUSIONS: In children with vesicoureteral reflux, although those with bilateral scarring have a significantly lower creatinine clearance than those with unilateral scarring, the severity of scar grade alone does not predict overall creatinine clearance with short-term follow-up.
Jenny H Yiee; Michael DiSandro; Ming-Hsien Wang; Adam Hittelman; Laurence S Baskin
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2010-05-15
Journal Detail:
Title:  Urology     Volume:  76     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-05     Completed Date:  2010-08-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  204-8     Citation Subset:  IM    
Copyright Information:
Copyright 2010. Published by Elsevier Inc.
Department of Urology, University of California, San Francisco, USA.
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MeSH Terms
Child, Preschool
Cicatrix / etiology,  radionuclide imaging*
Creatinine / urine*
Kidney Diseases / etiology,  radionuclide imaging*
Predictive Value of Tests
Radiopharmaceuticals / diagnostic use*
Severity of Illness Index
Technetium Tc 99m Dimercaptosuccinic Acid / diagnostic use*
Vesico-Ureteral Reflux / complications
Grant Support
Reg. No./Substance:
0/Radiopharmaceuticals; 60-27-5/Creatinine; 65438-08-6/Technetium Tc 99m Dimercaptosuccinic Acid

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