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Analysis of kideny static and dynamic scintigraphy after deflux treatment of vesicoureteral reflux

Introduction: The primary goal for the treatment of vesicoureteral reflux (VUR) in children is to reduce the incidence of recurrent urinary tract infections (UTIs) and possible renal damage. The aim of the study was to evaluate renal damage with DMSA static scintigraphy and possible disturbances of urinary tract with MAG3 dynamic scintigraphy in children treated with Deflux because of VUR.Material and methods: The 99 m Tc-DMSA was performed in 19 children (25 kidneys treated with Deflux therapy) and scans were graded as normal, pathologic with scars or equivocal. Dynamic renal scintigraphy was performed with 99mTc-MAG3 in 16 children (21 kidneys treated with Deflux) and in 5 children because of delayed elimination diuretic was injected. Scintigrams were performed 2 or more months after endoscopic treatment.Results: DMSA scintigraphy in 11 out of 25 treated kidneys was normal. In 8 kidneys we found renal damage with defect of parenchyma and in 6 equivocal findings were noticed. In 13 kidneys without deflux treatment (with or without reflux) 6 kidneys were normal, 2 had parenchymal defect and 5 kidneys had equivocal findings. MAG3 dynamic scintigraphy was good in 16 out of 21 treated kidneys. In 5 treated kidneys because of delayed elimination diuretic was injected with good respond and complete elimination of activity. Those 5 kidneys with disturbed elimination before endoscopic treatment had VUR grade III or more. In 11 untreated kidneys 2 kidneys had slower elimination of activity with good diuretic respond.Conclusions: After Deflux treatment DMSA scintigraphy had equal kidney damage in treated or untreated kidneys. The similar findings we found on MAG3 dynamic scintigraphy with slightly more delayed elimination in treated kidneys but with good diuretic respond. Further examination is still necessary to establish the proper timing for endoscopic treatment and its impact on renal damage and function because of similar result of damage in untreated kidneys

static and dynamic renal scintigraphy deflux children

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