Prognostic Value of DMSA Scan Following First UTI

To define the relationship between dimercaptosuccinic acid (DMSA) renal scans obtained within 15 days of the onset of first urinary tract infection (UTI), voiding cystourethrographies (VCUGs), and the risk of developing renal scars, 101 children (60 females) in Cuneo, Italy, were evaluated. Diagnostic criteria for UTI were a urine culture yielding a single organism with a colony count greater than 10⁵ combined with leukocyturia, bacteriuria, and/or hematuria. The mean age of the children was 18 months (range 1 month to 13.5 years) and the median time between onset of symptoms and diagnosis of UTI was 2 days. Children were diagnosed as having pyelonephritis if the DMSA scan displayed renal parenchyma involvement or cystopyelitis, defined as a UTI in the absence of a positive DMSA scan. The DMSA scan was graded as mild, moderate or severe when less than 25%, 25% to 50%, and greater than 50% of the kidney, respectively, was involved. Both contrast and radionucleotide VCUGs were graded 1 through …