The detection of reflux nephropathy in infants by 99mtechnetium dimercaptosuccinic acid studies

J Urol. 1991 Mar;145(3):542-6. doi: 10.1016/s0022-5347(17)38391-x.


Dimercaptosuccinic acid (DMSA) studies were performed in 113 infants less than 1 year old at risk of renal scarring. Of these patients 86 presented with urinary tract infection and 27 were asymptomatic. A voiding cystourethrogram was performed in all cases and excretory urography (IVP) was done in 99. More abnormalities were detected by DMSA study when compared to scars on IVP. When both studies were abnormal there was an excellent correlation on a site by site basis. Fever or systemic disorder was not a reliable sign to determine whether there was upper tract involvement with infection. The incidence of DMSA abnormalities in infants increased with high grade vesicoureteral reflux and decreased with low grade reflux. There was no significant difference in the incidence of abnormal kidneys between the infected and noninfected groups, suggesting that renal scarring may occur with sterile reflux.

Publication types

  • Comparative Study

MeSH terms

  • Female
  • Humans
  • Infant
  • Male
  • Organotechnetium Compounds*
  • Prospective Studies
  • Pyelonephritis / diagnostic imaging*
  • Pyelonephritis / etiology
  • Radioisotope Renography
  • Succimer*
  • Technetium Tc 99m Dimercaptosuccinic Acid
  • Urinary Tract Infections / diagnostic imaging
  • Urinary Tract Infections / etiology
  • Urography
  • Vesico-Ureteral Reflux / complications
  • Vesico-Ureteral Reflux / diagnostic imaging*


  • Organotechnetium Compounds
  • Technetium Tc 99m Dimercaptosuccinic Acid
  • Succimer