Document Detail

The role of vesicoureteral reflux in acute renal cortical scintigraphic lesion and ultimate scar formation.
MedLine Citation:
PMID:  18804801     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We assessed whether differences exist in the rates of acute photon defect and scar formation using dimercapto-succinic acid scintigraphy according to the presence and grade of vesicoureteral reflux. MATERIALS AND METHODS: A total of 389 patients with a first febrile urinary tract infection were enrolled. For all patients ultrasonography, dimercapto-succinic acid scintigraphy and voiding cystourethrography were performed. Dimercapto-succinic acid scintigraphy was performed within 5 days of and 6 months after diagnosis of urinary tract infection. Voiding cystourethrography was performed after the acute phase of urinary tract infection. The rates of acute photon defect and scar formation on dimercapto-succinic acid scintigraphy according to the presence and grade of vesicoureteral reflux were assessed. RESULTS: A total of 125 females and 264 males were included in the study. Of the patients 93 had refluxing urinary tract infection and 296 had nonrefluxing infection. The rate of acute photon defect (74.2% vs 32.1%, p = 0.0001) and the rate of ultimate scar change on followup dimercapto-succinic acid scintigraphy were significantly higher in patients with refluxing urinary tract infection (50% vs 18.3%, p = 0.0001). Positive linear association was noted between reflux grade and acute photon defect by linear association test (p = 0.002). No association was found between reflux grade and scar formation (p = 0.262). CONCLUSIONS: Although vesicoureteral reflux is not a prerequisite for development of acute photon defect and subsequent renal scarring, reflux itself might be an aggravating factor for acute photon defect and scar formation. There seems to be a correlation between reflux grade and frequency of acute photon defect on dimercapto-succinic acid scintigraphy but scar change occurs independently of reflux grade.
Mi Mi Oh; Myeong Heon Jin; Jae Hyun Bae; Hong Seok Park; Jeong Gu Lee; Du Geon Moon
Publication Detail:
Type:  Journal Article     Date:  2008-09-20
Journal Detail:
Title:  The Journal of urology     Volume:  180     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-20     Completed Date:  2008-11-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2167-70     Citation Subset:  AIM; IM    
Department of Urology, Korea University Hospital 80, Seoul, Republic of Korea.
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MeSH Terms
Acute Disease
Age Distribution
Chi-Square Distribution
Child, Preschool
Cicatrix / pathology,  radionuclide imaging
Cohort Studies
Follow-Up Studies
Kidney Cortex / pathology*,  radionuclide imaging
Kidney Diseases / etiology,  pathology,  radionuclide imaging*
Retrospective Studies
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Sex Distribution
Technetium Tc 99m Dimercaptosuccinic Acid / diagnostic use*
Urinary Tract Infections / epidemiology,  radionuclide imaging*
Vesico-Ureteral Reflux / complications*,  radionuclide imaging
Reg. No./Substance:
65438-08-6/Technetium Tc 99m Dimercaptosuccinic Acid
Comment In:
J Urol. 2008 Nov;180(5):1884-5   [PMID:  18801528 ]

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