RENAL PARENCHYMAL CHANGES IN CHILDREN WITH ACUTE PYELONEPHRITIS USING DMSA SCAN AND THE RELATIONSHIP WITH CERTAIN BIOLOGIC FACTORS

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ATAEI N.A.; SAFAEIAN B.; MADANI ABAS; ESFAHANI S.T.; ATAEI F.

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Journal: Tehran University Medical Journal Year:2009 | Volume:67 | Issue:2 Page(s): 125-131

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Title

RENAL PARENCHYMAL CHANGES IN CHILDREN WITH ACUTE PYELONEPHRITIS USING DMSA SCAN AND THE RELATIONSHIP WITH CERTAIN BIOLOGIC FACTORS

Author(s)

Keywords

ACUTE PYELONEPHRITISQ3

CHILDRENQ3

RENAL SCANQ3

DIMERCAPTOSUCCINIC ACIDQ3

LEUCOCYTOSISQ4

ERYTHROCYTE SEDIMENTATION RATEQ3

C- REACTIVE PROTEINQ3

Abstract

Background: Early diagnosis of renal parenchymal involvement in CHILDREN with ACUTE PYELONEPHRITIS (APN) using isotope scan and early treatment may decrease or prevent development of renal parenchymal lesions. We designed this study to assess the diagnostic value of certain biologic parameters in CHILDREN with first- episode of ACUTE PYELONEPHRITIS (APN) documented by 99m Tc-dimercaptosuccinic acid (DMSA) scintigraphy.Methods: We compared the laboratory findings of leukocyte count, ERYTHROCYTE SEDIMENTATION RATE (ESR) and serum C-reactive protein (CRP) levels with the results of the DMSA scans obtained within three days of admission. One hundred-two CHILDREN (93 girls and 9 boys aged 1 month–12 years (mean 2.85±2.92 years) were enrolled in the study. Of these patients, 203 renal units were investigated using scintigraphy. Voiding cystourethrography (VCUG) was performed in 98 CHILDREN (195 renal unit) when urine culture became negative.Results: In all CHILDREN one or both of kidneys had parenchymal involvement on scintigraphy. Changes on the DMSA scan were found in 178(88%) renal units during the acute phase. The extent of changes in DMSA scan were mild in 113.178(55.7%) renal units, moderate in 40.178(19.7%) and severe in 25.178(12.3%). When inflammatory markers were correlated with the development of the severe renal lesions, as assessed with DMSA scan, a highly significant correlation with both ESR (p=0.007) and leukocyte counts (p=0.02) were found. Conclusions: We conclude that the incidence of renal parenchymal involvement in Iranian CHILDREN with APN is very high. Although increased ESR and LEUCOCYTOSIS may be valuable markers for determination of severe renal parenchymal involvement, but these parameters and also CRP, were inadequate in distinguishing mild to moderate renal parenchymal involvement.

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APA: Copy

ATAEI, N.A., SAFAEIAN, B., MADANI, ABAS, ESFAHANI, S.T., & ATAEI, F.. (2009). RENAL PARENCHYMAL CHANGES IN CHILDREN WITH ACUTE PYELONEPHRITIS USING DMSA SCAN AND THE RELATIONSHIP WITH CERTAIN BIOLOGIC FACTORS. TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ), 67(2), 125-131. SID. https://sid.ir/paper/38739/en

Vancouver: Copy

ATAEI N.A., SAFAEIAN B., MADANI ABAS, ESFAHANI S.T., ATAEI F.. RENAL PARENCHYMAL CHANGES IN CHILDREN WITH ACUTE PYELONEPHRITIS USING DMSA SCAN AND THE RELATIONSHIP WITH CERTAIN BIOLOGIC FACTORS. TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)[Internet]. 2009;67(2):125-131. Available from: https://sid.ir/paper/38739/en

IEEE: Copy

N.A. ATAEI, B. SAFAEIAN, ABAS MADANI, S.T. ESFAHANI, and F. ATAEI, “RENAL PARENCHYMAL CHANGES IN CHILDREN WITH ACUTE PYELONEPHRITIS USING DMSA SCAN AND THE RELATIONSHIP WITH CERTAIN BIOLOGIC FACTORS,” TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ), vol. 67, no. 2, pp. 125–131, 2009, [Online]. Available: https://sid.ir/paper/38739/en

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