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Quantitative 99mTc-DMSA uptake in experimental pyelonephritis.

M L Godley1, R A Risdon, I Gordon

  • 1The Institute of Child Health and the Great Ormond Street Hospital for Children NHS Trust, London, England, UK.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
|April 21, 1999
PubMed
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Quantitative 99mTc-dimercaptosuccinic acid (DMSA) uptake studies in pigs with pyelonephritis show that reduced kidney function in diseased kidneys is compensated by increased uptake in healthy kidneys. Treatment did not fully restore function in irreversible defect groups.

Area of Science:

  • Nephrology
  • Nuclear Medicine
  • Veterinary Pathology

Background:

  • Unilateral reflux-related pyelonephritis can lead to kidney damage.
  • Quantitative 99mTc-dimercaptosuccinic acid (DMSA) scintigraphy is used to assess renal function.

Purpose of the Study:

  • To investigate quantitative 99mTc-DMSA uptake in pigs with induced unilateral pyelonephritis.
  • To correlate changes in DMSA uptake with imaging and pathology before and after treatment.

Main Methods:

  • 53 pigs underwent quantitative 99mTc-DMSA uptake studies at baseline (Q1), after infection (Q2), and post-treatment (Q3).
  • Pigs were categorized into groups based on renal imaging defects: normal (A), reversible (B), and irreversible (C).
  • Antimicrobial treatment was administered to groups B and C.

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Main Results:

  • Pyelonephritis reduced differential uptake in affected kidneys (Groups B & C).
  • Contralateral kidneys showed increased absolute uptake in Groups B & C, compensating for diseased kidney function.
  • Reduced differential uptake persisted post-treatment, with less sustained global uptake increase in Group C.

Conclusions:

  • Unilateral pyelonephritis causes reduced differential uptake in affected kidneys, more pronounced with irreversible defects.
  • Increased contralateral kidney uptake compensates for diseased kidney function, masking overall DMSA accumulation changes.
  • 99mTc-DMSA scintigraphy did not differentiate reversible from irreversible defects effectively in this model.