TITLE:
Short Term Prognostic Utility of Tc-99m DMSA Renal Imaging in Sepsis Induced Acute Renal Failure; Provisional Data
AUTHORS:
Amr Amin, Hatem Nasr, Gehan Younis, Hatem Gamal
KEYWORDS:
Acute Renal Failure; Tc-99m DMSA; Sepsis Induced Acute Renal Failure
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.4 No.12,
December
25,
2013
ABSTRACT: Background: Sound prognostic data in sepsis induced acute renal failure (SARF) are lacking
especially on the short term outcome [STO] in the intensive care unit [ICU]. We
addressed the use of Tc-99m DMSA [2,3-dimercaptosuccinicacid] renal cortical imaging as a
prognostic tool in SARF. Methods: Forty patients with acute renal failure due to sepsis [age range 15-74 years; median 44.5] were subjected
for full history taking complete physical examination, routine ICU monitoring,
routine laboratory investigations, APACHE II [Acute Physiology and Chronic Health
Evaluation] and SOFA [Sequential Organ Failure Assessment] together with Tc-99m
DMSA cortical renal scintigraphy. Patients’ death in the ICU or discharge was
considered as the end point of the study representing the so-called short term
outcome [STO]. Results: 25%
mortality rate [10/40] was found along the admission period in the ICU. All
non-survivors were abnormal with DMSA imaging [NPV & PPV 100% & 66.7%
respectively]. Abnormal DMSA cases showed significant positive associations
with serum creatinine at admission [r = 0.5; P 0.02]; admission duration [r = 0.4;
P 0.002]; APACHE II score [r = 0.5; P 0.004] and STO [r = 0.4; P 0.03].
Statistically significant difference was elicited between subjects with normal
and abnormal DMSA regarding the same parameters. Conclusion: This preliminary data could raise Tc-99m DMSA renal
imaging as a prognostic tool in SARF that could allow influential interference
to prohibit dramatic outcomes as mortality.