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At least 451 records · Page 25Linked to original sources
PubMed1988

Evaluation of 99mtechnetium-dimercapto-succinic acid renal scans in experimental acute pyelonephritis in piglets.

We evaluated the sensitivity and specificity of 99mtechnetium-dimercapto-succinic acid renal scans in the detection and localization of experimental acute pyelonephritis in piglets. To create pyelonephritis vesicoureteral reflux of infected urine was surgically induced in 22 piglets. Nine animals were evaluated with a dimercapto-succinic acid renal scan at 1 week and 13 at 2 weeks. Autopsy and histopathological examination of the kidneys were performed subsequently. The location and extent of the inflammatory response found on histopathological examination were compared to dimercapto-succinic acid renal scan findings in a blinded fashion. Of the 22 kidneys subjected to vesicoureteral reflux 15 had positive histopathological findings of acute pyelonephritis, including 13 detected by the dimercapto-succinic acid renal scan findings. The 2 kidneys in which inflammation was not detected had only minimal grade I lesions and were grossly normal. There were no false positive scans in any of these kidneys. The sensitivity of the scan for detection of acute pyelonephritis in the kidneys subjected to reflux was 87 per cent and the specificity was 100 per cent. Furthermore, in these same kidneys the dimercapto-succinic acid renal scan findings correctly predicted the presence or absence of individual pyelonephritic lesions in 62 of 66 poles for an over-all agreement rate of 94 per cent. Thus, dimercapto-succinic acid renal cortical imaging is a highly sensitive and reliable imaging modality to detect and localize experimental acute pyelonephritis in piglets.

Acute Disease↗
PubMed1987

Indications for 99mtechnetium dimercapto-succinic acid scan in children.

The 99mtechnetium dimercapto-succinic acid scan provides an image of functional renal parenchyma. This static scan has specific indications and cannot be used simply in place of a 99mtechnetium diethylenetriaminepentaacetic acid scan. The major clinical indications for this investigation are the detection and/or evaluation of a renal scar, the small or absent kidney, an occult duplex system, certain renal masses, systemic hypertension or suspected vasculitis. The physiology of the 99mtechnetium dimercapto-succinic acid scan is reviewed briefly.

Child↗
PubMed1986

Sensitivity of 99mtechnetium-dimercaptosuccinic acid for the diagnosis of chronic pyelonephritis: clinical and theoretical considerations.

Radioisotopic renal imaging proved to be much more sensitive than excretory urography in diagnosing renal parenchymal damage in 6 children with acute febrile urinary tract infections. This increased sensitivity may affect clinical management. More importantly, it may change the interpretation of scientific studies evaluating the natural history and treatment of vesicoureteral reflux.

Child↗
PubMed1985

Renal accumulation of 99mTc-DMSA in the artificially perfused isolated rat kidney.

In order to investigate aspects of the renal handling of 99mTc-DMSA, 68 isolated rat kidneys were artificially perfused. The experimental groups were: Group 1 (no. = 32)-oxygenated filtering kidneys; Group 2 (no. = 29)-oxygenated non-filtering kidneys; Group 3 (no. = 7)-anaerobic non-filtering kidneys. We conclude that the 99mTc-DMSA complex is strongly bound to albumin, is not filtered and is removed from perfusion fluid through the renal peritubular capillary route and that this occurs by an active process which depends upon aerobic metabolism. This process has a high capacity and is not inhibited by probenecid.

Animals↗
PubMed1984

Reversible hydronephrosis in the rat: a new surgical technique assessed by radioisotopic measurements.

A new technique for experimental reversible hydronephrosis in the rat was developed. A noninvasive radioisotopic investigation, using Tc-99m dimercaptosuccinic acid, permitted sequential assessment of the separate renal function at different stages of the study. After 1 week of unilateral ureteral obstruction, reversibility was obtained by the removal of the obstructive device. Ten days after the obstruction release, the ipsilateral kidney had returned to 71 per cent of its preligation uptake value. Histological findings demonstrated the reversibility of the surgical obstruction.

Animals↗
PubMed1983

Preoperative and postoperative cortical function of the kidney with staghorn calculi assessed by 99mtechnetium-dimercaptosuccinic acid renal scintigraphy.

99mTechnetium dimercaptosuccinic acid renal scintigraphy, consisting of the cortical image and dimercaptosuccinic acid renal uptake rate, was used to assess preoperative and postoperative renal function in 55 patients with staghorn calculi. In 14 of 20 patients who had undergone extended pyelolithotomy and in 4 of 22 who had undergone nephrolithotomy there was an increase or no change in the postoperative dimercaptosuccinic acid renal uptake in the surgically treated kidney. However, there was no increase in the postoperative dimercaptosuccinic acid renal uptake in the patients who had undergone pyelolithotomy combined with nephrotomy or partial nephrectomy. Eight per cent of the preoperative dimercaptosuccinic acid renal uptake rate in the diseased kidney seems to be the absolute level for predicting the postoperative recovery of renal function. Dimercaptosuccinic acid renal images provide evidence of morphological changes in the cortex of the kidney with stones and the dimercaptosuccinic acid uptake rate is a useful adjunct for quantitative assessments of preoperative and postoperative residual cortical function.

Adult↗
PubMed1982

A clinical study of 99mTechnetium dimercaptosuccinic acid uptake in obstructed kidneys: comparison with the creatinine clearance.

We studied 17 hydronephrotic kidneys owing to stenosis of the pyeloureteral junction. Preoperative uptake of 99mtechnetium dimercaptosuccinic acid was compared to early postoperative unilateral creatinine clearance, measured by urine collection from the nephrostomy tube. An excellent correlation was found. Therefore, uptake of 99mtechnetium dimercaptosuccinic acid represents a reliable parameter of renal function even in the presence of severe urinary tract obstruction. However, 99mtechnetium dimercaptosuccinic acid uptake should be measured more than 24 hours after injection of the tracer.

Adolescent↗
PubMed2003

Comparison of relative renal function by renal scintigraphy and lateralized creatinine clearance in children with bilateral vesicoureteral reflux.

OBJECTIVES: To evaluate the relative renal function on preoperative and postoperative renal scintigraphy with lateralized creatinine clearance. Multiple factors affect renal blood flow and glomerular filtration that alter the relative renal function calculated by renal scintigraphy. The relative renal function according to renal scintigraphy in children with bilateral vesicoureteral reflux has not been compared with lateralized creatinine clearance. METHODS: We retrospectively reviewed the charts of 45 children treated surgically for bilateral vesicoureteral reflux. The average age at time of reimplantation was 5.3 years. Bilateral ureteral catheters were placed intraoperatively. Lateralized creatinine clearance was measured with 24-hour urine collections postoperatively from each catheter. Bladder catheterization was not performed during the renal scans. RESULTS: Thirty-six of 45 children had preoperative 1 to 3-minute relative renal function assessed by scintigraphy, 28 had a postoperative assessment, and 24 had both. Preoperative relative renal function ranged between 51% and 94% (mean 61.3%) in the higher functioning kidney. Postoperative renal function ranged from 47% to 90% (mean 60.5%) in the higher functioning kidney. A strong correlation existed between preoperative relative renal function and lateralized creatinine clearance (P <0.0001). Similarly, a significant correlation existed between the postoperative assessment and lateralized creatinine clearance (P <0.0003). No significant difference occurred between the preoperative and postoperative 1 to 3-minute relative renal function (P = 0.3552). CONCLUSIONS: The 1 to 3-minute relative renal function determined by renal scintigraphy accurately reflects the relative renal function determined by lateralized creatinine clearance. Bladder catheterization does not appear necessary for accurate determination of relative renal function by renal scan even in the presence of bilateral reflux.

Adolescent↗
PubMed1991

Renal dynamics after pyeloplasty.

Dismembered pyeloplasty was done on 12 renal units for ureteropelvic junction obstruction. Postoperatively, response of repaired kidney to standard diuretic dose of furosemide (0.3 mg/kg) was evaluated. Also renal pelvic pressures at rest and during diuresis were measured. All renal units responded to the diuretic by increasing their urine output an average of three times over baseline value. Renal pelvic pressure registration revealed no significant change after diuresis over baseline values. Diuretic technetium-99 DTPA renal scans were obtained two to six months postoperatively and compared with preoperative scans; the best results were obtained in renal units whose intrapelvic pressures did not exceed 10 cm of water in the immediate postoperative period.

Female↗
PubMed1999

Utility of SPECT DMSA renal scanning in the evaluation of children with primary vesicoureteral reflux.

OBJECTIVES: DMSA renal scanning is more sensitive than ultrasound in detecting renal parenchymal scars. We proposed to determine the utility of single-photon emission computed tomography (SPECT) dimercaptosuccinic acid (DMSA) renal scanning in children with primary vesicoureteral reflux (VUR). METHODS: During a 24-month period, we evaluated the charts of 368 patients who had undergone SPECT DMSA renal scanning for primary VUR. Patients were divided into three age groups: (a) less than 1 year, (b) between 1 and 5 years, and (c) older than 6 years. Renal scars were deemed severe or focal. The data were analyzed to evaluate the utility of SPECT DMSA scanning in children with primary VUR and to determine the indications for performing SPECT DMSA. We also evaluated the sensitivity of recent renal ultrasound technology in detecting focal and diffuse scars. RESULTS: One hundred twenty-eight patients were younger than 1 year at presentation. These included 24 cases that were detected prenatally. One hundred eighty-five were between the ages of 1 and 5 years, and 55 were 6 years or older. Reflux nephropathy at presentation was found in 99 (26.9%) of 368 patients. DMSA scanning changed the treatment in only 13 patients (3.5%). When scarring was diffuse, ultrasound examination correlated 100% with DMSA scanning; when focal scarring was present, the correlation was poor. CONCLUSIONS: Our results suggest that DMSA scans should be tailored to children who have ultrasound abnormalities, high-grade reflux, or recurrent breakthrough urinary tract infections. These guidelines will result in a substantial cost savings and a significant decrease in radiation exposure.

Child↗
PubMed1996

Quantitative technetium-99M dimercaptosuccinic acid renal scanning in children.

OBJECTIVES: To develop a method for assessing absolute renal function (as well as morphology) in children, using gamma camera imaging of intravenously injected technetium-99m (99mTc) dimercaptosuccinic acid (DMSA). METHODS: Forty-five children (ages 1 week to 10 years; mean, 2.0 years) were imaged using a planar technique in which not only the appearance but the absolute amount of intravenously administered 99mTc DMSA taken up by the kidneys was calculated for each child and compared with contemporaneous determinations of creatinine clearance. RESULTS: There was a close correlation between the absolute DMSA uptake and creatinine clearance (r = 0.752). CONCLUSIONS: Renal function in children, expressed as creatinine clearance, can be accurately estimated by measuring absolute DMSA uptake with planar gamma camera imaging using 99mTc DMSA.

Child↗
PubMedDate not supplied

Short-term exposure to dietary Pb and/or DMSA affects dopamine and dopamine metabolite levels in the medulla, optic tectum, and cerebellum of rainbow trout (Oncorhynchus mykiss).

Rainbow trout (Oncorhynchus mykiss) were randomly assigned to one of the following dietary exposure conditions: lead (Pb) solvent (2% nitric acid), meso-2,3-dimercaptosuccinic acid (DMSA) solvent (0.1 N NaOH), Pb, DMSA, Pb followed by Pb solvent, or Pb followed by DMSA. Medulla, cerebellum, and optic tectum homogenates were analyzed for dopamine (DA), homovanillic acid (HVA), and 3,4-dihydroxyphenylacetic acid (DOPAC). DA levels in all brain regions tended to be highest for trout exposed to dietary Pb followed by dietary DMSA. DA levels were elevated for trout exposed to dietary DMSA and Pb followed by Pb solvent. DA levels were below control levels for trout exposed to Pb only. HVA levels varied across brain regions. However, HVA levels in all brain regions tended to be elevated for trout exposed to dietary DMSA and Pb followed by Pb solvent. DOPAC levels across all brain regions were below control levels for trout dietary exposed to DMSA, Pb only, Pb followed by Pb solvent, and Pb followed by DMSA. These data indicate that Pb and/or DMSA have the potential of altering DA, HVA, and DOPAC levels in the medulla, cerebellum, and optic tectum. The animal model of short-term dietary exposure to Pb and DMSA, both alone and sequentially, to mimic dietary exposure to Pb and the oral delivery of DMSA, that our laboratory has developed, may be useful in future studies aimed at characterizing the neurobiological mechanisms by which Pb and/or DMSA alter neurotransmitter levels and behavior.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1978

Treatment of lead poisoning by 2,3-dimercaptosuccinic acid.

2,3-Dimercaptosuccinic acid (D.M.S.), a new orally effective agent for the treatment of heavy-metal intoxication, was administered to five lead-poisoned smelter workers for six days at dosages ranging from 8.4--12.7 mg/kg/day on the first day to 28.1--42.2 mg/kg/day on the last day. Mean blood-lead concentration decreased significantly from an initial value of 97 +/- 6 microgram/dl to 43 +/- 4 microgram/dl on the last day. Urinary lead excretion was significantly raised. D.M.S. was very well tolerated with no signs of toxicity and no effect on urinary zinc, calcium, magnesium, or iron excretion. Urinary copper excretion was significantly increased, but the magnitude of that effect was not clinically important. D.M.S. seems to be safe and effective for the treatment of lead poisoning.

Administration, Oral↗
PubMed1997

Are younger children at highest risk of renal sequelae after pyelonephritis?

BACKGROUND: The general belief about the relation between risk of renal sequelae after pyelonephritis and age is that infants are at highest risk and children older than 5 years at lower risk. This assumption has led to differences in treatment based on age. The aim of this prospective study was to investigate the occurrence of renal lesions in children aged 0-16 years. METHODS: Between May, 1994, and January, 1996, all children aged 0-16 years who were admitted to our department with a diagnosis of probable pyelonephritis and a positive urine culture were included in this prospective study. All patients received antibiotics for 7-21 days. During the acute phase of urinary-tract infection, scintigraphy with technetium-99m-dimercaptosuccinic acid (DMSA) and ultrasonography were done. Voiding cystourethrography was undertaken at least 6 weeks after the end of antibiotic treatment. When scintigraphy showed renal parenchymal lesions, repeat scintigraphy was done after at least 2 months to assess the progression of renal lesions. For the analysis, children were grouped by age according to presumed risk of renal sequelae after pyelonephritis: high risk (< 1 year), moderate risk (1-5 years), low risk (> 5 years). FINDINGS: 201 patients were enrolled in the study (119 < 1 year, 47 aged 1-5 years, 35 > 5 years). During the acute phase of urinary-tract infection, renal lesions were found in 66 (55%) infants under 1 year, in 37 (79%) children aged 1-5 years, and in 24 (69%) children older than 5 years. Of these 127 children, 108 underwent repeat scintigraphy after an average of 3 months (50 < 1 year, 36 aged 1-5 years, 22 > 5 years). Overall, renal scars were found on repeat scintigraphy in 20 (40%) infants under 1 year, in 31 (86%) children aged 1-5 years, and in 14 (64%) children older than 5 years. 38 (36%) of these 65 patients had vesicoureteric reflux. Among 88 children who had a first documented urinary-tract infection and underwent repeat scintigraphy, renal scars were found in 20 (43%) under 1 year, in 26 (84%) aged 1-5 years, and in eight (80%) older than 5 years. INTERPRETATION: This study did not confirm the conventional view that the risk of renal scars after pyelonephritis diminishes with age. We believe that all children, irrespective of age, will benefit from any measure that prevents the development of renal sequelae.

Adolescent↗