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.
Cite this paper
A. Amin, H. Nasr, G. Younis and H. Gamal, "Short Term Prognostic Utility of Tc-99m DMSA Renal Imaging in Sepsis Induced Acute Renal Failure; Provisional Data," International Journal of Clinical Medicine
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