Relationship between 99mTc-DTPA, 99mTc-DMSA and glomerular filtration rate by calculated γ - Camera method in kidney with unilateral renal scar

Abstract

Aim: To evaluate the relationship between renal abnormalities detected by 99mTc-Dimercaptosuccinic acid (99mTc-DMSA) scans and glomerular filtration rate estimated by γ-camera method using 99mTc-DTPA (Diethylene-triamine-pentaacetate dynamic renal scintigraphy) in patients with renal parenchymal scarring.

Methods: We selected children who were followed up in our Pediatric Clinic for recurrent urinary tract infections and developed unilateral renal parenchymal scarring after these infections. We compared 99mTc-DMSA difference rates, glomerular filtration rate (GFR) calculated by γ -camera method and 99mTc-DTPA difference rates in the affected kidney.

Results: Of the 23 patients, 14 (60.9%) were female and 9 (39.1%) were male. The mean age of the patients was 10.41 ± 4.49 years. In the comparison of 99mTc-DMSA scans and glomerular filtration rate calculated by γ -camera method using 99mTc-DTPA in the renal parenchymal scarring kidney, there was no significant difference in the Tc-99m-DTPA (%) difference rates between the scarring and non-scarring kidney (p=0.750). However, there was a significant decrease in GFR (ml/min) values in the scarring kidney compared to the non-scarring kidney (p=0.025).

Conclusions: We found that GFR measurement provides earlier information than other methods in assessing renal function with DTPA and DMSA in patients with scarred kidneys, before irreversible loss of function occurs. GFR value is statistically more significant than DTPA and DMSA evaluation.