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

Background/Objectives: This prospective study aimed to assess residual cortical function at follow-up in patients with traumatic renal injuries using Tc-99m dimercaptosuccinic acid (DMSA) single-photon emission computed tomography (SPECT) and evaluate clinical factors associated with residual cortical function. Methods: A total of 59 patients with renal injury who were treated non-operatively and underwent Tc-99m DMSA SPECT at the follow-up (3 months ± 1 year) were enrolled. The correlation between residual cortical function and renal injury grades, alongside other clinical factors, was analysed. Results: The mean age of the patients was 49.10 ± 22.67 years, and 35 (59.3%) were male. In total, 28 patients (47.5%) had high-grade injuries, and 20 (33.9%) underwent a renal artery endovascular procedure (RAE). High-grade renal injury correlated with laboratory renal function and DMSA scintigraphic parameters, especially SPECT split renal function (SRF) (ρ = -0.565; p < 0.001); meanwhile, a significant decrease existed in DMSA scintigraphic parameters in patients with high-grade injuries. Furthermore, laboratory renal function and DMSA scintigraphic parameters were significantly decreased in patients who underwent RAE. The multivariable analysis highlighted that high grade renal injury (odds ratio [OR], 9.50; 95% confidence interval (CI), 1.78-50.61; p = 0.008) and RAE (OR, 5.15; 95% CI, 1.07-24.88; p = 0.041) were significant factors associated with decreased residual cortical function. Conclusions: Tc-99m DMSA SPECT provides accurate information on the residual cortical function at follow-up in patients with renal injuries. Additionally, high-grade renal injury and RAE were associated with decreased residual cortical function.