Short Term Prognostic Utility of Tc-99m DMSA Renal Imaging in Sepsis Induced Acute Renal Failure;Provisional Data  

作　　者：Amr Amin Hatem Nasr Gehan Younis Hatem Gamal 

机构地区：[1]Intensive Care Unit, Faculty of Medicine, Cairo University, Cairo, Egypt [2]Nuclear Medicine Unit, Faculty of Medicine, Cairo University, Cairo, Egypt

出　　处：《International Journal of Clinical Medicine》2013年第12期543-547,共5页临床医学国际期刊（英文）

摘　　要：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.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.

关 键 词：ACUTE RENAL FAILURE TC-99M DMSA SEPSIS Induced ACUTE RENAL FAILURE 

分 类 号：R73[医药卫生—肿瘤]