| Does severity of renal scarring on DMSA scan predict abnormalities in creatinine clearance? | |
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MedLine Citation:
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PMID: 20472269 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Jenny H Yiee; Michael DiSandro; Ming-Hsien Wang; Adam Hittelman; Laurence S Baskin |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural Date: 2010-05-15 |
Journal Detail:
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Title: Urology Volume: 76 ISSN: 1527-9995 ISO Abbreviation: Urology Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-05 Completed Date: 2010-08-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0366151 Medline TA: Urology Country: United States |
Other Details:
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Languages: eng Pagination: 204-8 Citation Subset: IM |
Copyright Information:
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Copyright 2010. Published by Elsevier Inc. |
Affiliation:
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Department of Urology, University of California, San Francisco, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Child Child, Preschool Cicatrix / etiology, radionuclide imaging* Creatinine / urine* Female Humans Kidney Diseases / etiology, radionuclide imaging* Male Predictive Value of Tests Radiopharmaceuticals / diagnostic use* Severity of Illness Index Technetium Tc 99m Dimercaptosuccinic Acid / diagnostic use* Vesico-Ureteral Reflux / complications |
| Grant Support | |
ID/Acronym/Agency:
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MO1 RR 01271/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Radiopharmaceuticals; 60-27-5/Creatinine; 65438-08-6/Technetium Tc 99m Dimercaptosuccinic Acid |
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