Effect of percutaneous nephrolithotomy on renal functions in children: assessment by quantitative SPECT of (99m)Tc-DMSA uptake by the kidneys

• Published in: Renal failure Vol. 37; no. 7; p. 1118
• Main Authors: Cicekbilek, Izzet, Resorlu, Berkan, Oguz, Ural, Kara, Cengiz, Unsal, Ali
• Format: Journal Article
• Language: English
• Published: England 01-08-2015
• Subjects: Adolescent; Child; Child, Preschool; Female; Humans; Kidney - surgery; Kidney Calculi - surgery; Male; Nephrostomy, Percutaneous - methods; Prospective Studies; Radiopharmaceuticals - administration & dosage; Technetium Tc 99m Dimercaptosuccinic Acid - administration & dosage; Tomography, Emission-Computed, Single-Photon - methods; renal parenchymal scar; renal function; stone disease; Percutaneous nephrolithotomy; renal scintigraphy
• ISSN: 1525-6049
• DOI: 10.3109/0886022X.2015.1056063

To determine the impact of percutaneous nephrolithotomy (PNL) on global and regional renal function in children.
In total, 40 children (41 renal units) undergoing PNL were included in this prospective study. All patients were evaluated using quantitative single-photon emission computed tomography (QSPECT) with technetium-99 m-dimercaptosuccinic acid ((99m)Tc-DMSA) examinations before and 3 months after surgery.
The mean age was 9.5 years (range, 3-16), and the mean stone size was 3.4 cm (range, 2-6.5). Of the cases, 39 (95%) were managed as being stone-free after a single session of PNL. After additional treatment procedures, 40 (97.5%) of the cases were managed as being stone-free. Of the 41 renal units, new focal cortical defects on (99m)Tc-DMSA scans were seen in 4 (9.7%) patients. Total relative uptake in the treated kidneys increased from 42.3% to 44.1%. The mean creatinine level before PNL was 1.18 ± 0.45 (0.8-1.6) mg/dL compared with 1.16 (0.7-1.5) mg/dL by the end of the follow-up period (not statistically significantly different, p > 0.05).
PNL in children is a safe and feasible method for the maximal clearance of stones. QSPECT of (99m)Tc-DMSA confirmed that renal function is preserved or even improved after percutaneous stone removal.