engleski

Differences between the first sand the second renal scintigraphy in children with recurrent UTI

Objectives: We analyzed DMSA scintigraphy in children with recurrent UTI to find parenchymal damage. Methods: We analyzed 117 children (234 kidneys), 80 girls and 37 boys, aged from 3 months to 12 years at the time of the fi rst DMSA. All children underwent US and voiding cystourethrography. VUR was detected in 140 kidneys. Second DMSA was performed one to fi ve years after the fi rst. All children were on the antibiotic uroprophylaxis, and some of them were treated surgically withantireflux procedures. At the time of second DMSA VUR were found in 95 kidneys. DMSA scans were graded as normal, pathologic with scars or equivocal, and compared with presence of VUR and US findings. Results: On the fi rst DMSA out of 234 kidneys 63 were normal, 116 equivocal, and 55 pathologic while on the second DMSA 87 kidneys were normal, 78 were equivocal and 69 pathologic (p<0.01). On second DMSA kidneys with VUR(140 vs 95) and without VUR (94 vs 139) were significantly different (p<0.01). Comparison of DMSA in kidneys without VUR showed signifi cantly increased number of normal (31 vs 53), and pathologic (17 vs 46) fi ndings. 25 kidneys had pathologic US, 19 with pelvic dilatation, and 16 with parenchymal damage. Conclusions: On second DMSA higher pathologic kidneys without VUR could be results pontaneous or surgical disappearance of VUR in damaged kidneys and less equivocal and more normal fi ndings might be the result of antibiotic prophylactic treatment which is obligatory and very important for the prevention of renal damage.

enal scintigraphy recurrent uroinfection

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