Evaluation of Critical Function in Pathologic Solitary Kidneys Using 99mTc-DMSA Scintigram / 대한신장학회잡지

ABSTRACT

OBJECTIVE: To make decision of the dialysis or transplantation in the patient with renal failure should be demanded the precise measurement serving the critical level of the renal function. 99mTc- DMSA is a new renal scanning agent that provides a good quality of renal image as a result of preferential cortical accumulation and also makes feasible a quantitative assessment of renal function. We want to know the critical level of the renal function with 99mTc-DMSA scanning in the experimental rabbits with pathologic solitary kidney. MATERIALS AND METHODS: We made artificial left hydronephrosis having left ureter ligation at 2 weeks after performing right functional nephrectomy with vessels ligation in 20 experimental rabbits. At 24, 48, and 72 hours after then, 99mTc-DMSA renal uptake rates, serum urea nitrogen, and creatinine were checked to evaluate the critical levels of renal function impairment. RESULTS: Before left ureteral ligation 99mTc- DMSA renal uptake rates, serum urea nitrogen, and creatinine were 9.59+/-1.14%(mean+/-SD), 28.0+/-5.2 mg/dl, and 1.3+/-0.2 mg/dl respectively. Those of the fifteen pathologic solitary kidney at 24 hours after ureter ligation were 4.37+/-1.68%, 74.2+/-20.2mg/dl, and 7.6+/-2.4mg/dl respectively. Those of the thirteen at 48 hours were 4.25+/-1.09%, 126.0+/-33.5mg/dl, and 9.8+/-3.5mg/dl respectively. And serum urea nitrogen and creatinine of the twelve at 72 hours were 183.9+/-51.0mg/dl, and 14.4+/-2.3mg/dl respectively. 99mTc- DMSA renal uptake rates appeared indiscriminate values with approaching to death while the levels of serum urea nitrogen and creatinine revealed increasing values. CONCLUSION: 99mTc-DMSA renal scan was one of the appropriate tests to evaluate the critical level of renal function impairment.