The Association of Kidney's GFR and Serum Creatinine Levels with Renal Scarring through 99mTc-Glucoheptonate Radiopharmaceutical Scan in Patients with Urinary Tract Infection

Abstract

UTI (urinary tract infection) is a leading case of renal scarring. Most of nephrons are found in kidney cortex, so it is important for early diagnosis of scarring. In this study, we investigated if scarring affects GFR (glomerular filtration rate) and serum level of creatinine through dual multipurpose 99mTc-GH (99mTc-Glucoheptonate) scintigraphy in patients with UTI. Methods: During this study 21 patients with UTI were studied by 99mTc-GH scan. For performing scintigraphy, the patient was injected by 370-555 MBq of 99mTc-GH and studied through two steps including dynamic (immediately after injection) and static (2-3h after injection) phases. The results were evaluated by appropriate analytical methods. Moreover, five patients were studied by both 99mTc-DMSA/GH (99mTc-dimercaptosuccinic acid and 99mTc-Glucoheptonate) to show 99mTc-GH scan is beneficial for detection of additional problems. Results: The results showed that there is an association between right/left kidney scarring and related GFR. Furthermore, the odds of decreased right and left kidney GFR with scarring is 12.64 and 11.89 times more than normal kidney respectively. Also, there is a significant association between renal scarring and serum level of creatinine. The study showed that the odds of increased serum level of creatinine in patients with scarring are 6.75 times more than patients without scarring. Moreover, the survey of five patients with both 99mTc-DMSA/GH scans showed 99mTc-GH could be helpful with diagnosis of some renal problems as well as scarring. Conclusion: Through this study by 99mTc-GH, it was demonstrated that kidney glomerular filtration rate and serum level of creatinine are associated with renal scarring. Furthermore, it was shown that 99mTc-GH scintigraphy could detect dilatation and abstraction of collection system in addition to renal scarring through static/dynamic renal scintigraphy.