All issues > Volume 36(10); 1993

Original Article

J Korean Pediatr Soc. 1993;36(10):1402-1406. Published online October 15, 1993.

Renal Scarring in Relation to Vesicoureternal Reflux in Uriary Tract Infection

Kwang Sun KS Han¹, Dong Jin DJ Choi¹, Sung Ho SH Cha¹, Byoung Soo BS Cho¹, Young Tae YT Ko², Sun Wha SW Lee²

¹Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea
²Department of Diagnostic Radiology, College of Medicine, Kyung Hee University, Seoul, Korea

Abstract

The vesicoureteral reflux (VUR) is frequently found among the patients with urinary tract infection (UIT) and some patients with VUR progress to reflux nephropathy. The presence of scarring at UIT is an important determinant in the selection of those at risk of progressive damage. 99m Technetium dimercaptosuccinic acid (99mTc-DMSA) is a renal scanning agent provides a good quality of renal image as a result of preferential cortical accumulation. 99mTc-DMSA scan and VCUG were performed in 133 patients diagnosed UTI at pediatric department of Kyung Hee University, College of Medicine from May, 1990 to May, 1992 The results were as follows: 1) VUR was seen in 27 children among 133 patients with UTI. The incidence was 20.3%. Under 1 year of age. Male to female ratio was higher incidence of VUR. 2) Incidence of renal scarring was higher in patients with VUR than those of without VUR. 3) Grading of VUR in relation to age, the older the age, the lower the grade. 4) There is no correlation between renal scarring and grades of VUR. 5) In distribution of renal scarring, it was found to have tendency to develop at upper polar area, there was diffuse and multiple in patients with VUR. In conclusion, the incidence of renal scarring was related to the age of onset, duration of UTI and the severity of the VUR and 99mTc-DMSA scan is mandatory in patient with UTI even without VUR in order to detect early phase of renal scarring.

Keywords :Urinary tract infection, Vesicoureteral reflux, DMSA scan.