Assessment of Residual Cortical Function by Using Tc-99m DMSA SPECT at Follow-Up in Non-Operatively Treated Patients...

Area of Science:

• Nephrology
• Radiology
• Nuclear Medicine

Background:

• Traumatic renal injuries can impact long-term kidney function.
• Assessing residual cortical function is crucial for patient management.
• Tc-99m DMSA SPECT is a valuable tool for evaluating renal function.

Purpose of the Study:

• To evaluate residual cortical function in patients with traumatic renal injuries using Tc-99m DMSA SPECT.
• To identify clinical factors associated with decreased residual cortical function.

Main Methods:

• Prospective study of 59 non-operatively treated patients with renal injury.
• Tc-99m DMSA SPECT performed at 3 months ± 1 year follow-up.
• Correlation analysis between residual function and injury grade, renal artery embolization (RAE), and other clinical factors.

Main Results:

• High-grade renal injury (47.5%) and RAE (33.9%) were common.
• High-grade injury and RAE correlated with decreased DMSA scintigraphic parameters, including SPECT split renal function (SRF).
• Multivariable analysis confirmed high-grade injury (OR 9.50) and RAE (OR 5.15) as significant factors for reduced residual function.

Conclusions:

• Tc-99m DMSA SPECT accurately quantifies residual cortical function post-renal injury.
• High-grade renal injury and RAE are independently associated with diminished residual renal function.
• These findings aid in predicting outcomes and guiding treatment for traumatic renal injuries.