Lower moiety heminephroureterectomy in the duplex refluxing kidney: the accuracy of isotopic scintigraphy in functional assessment.
OBJECTIVE
To determine the accuracy of dimercaptosuccinic acid (DMSA) scintigraphy in assessing the differential function between upper and lower moieties of a refluxing duplex system.


METHODS
Between 1990 and 1996, 20 patients underwent lower moiety heminephroureterectomy. All patients had their differential renal function assessed by DMSA scintigraphy before and after surgery, the results being assessed by comparing the predicted and actual loss of renal function.


RESULTS
The mean (SD, range) function attributed to the scarred lower moiety (predicted loss of function) was 4.3 (4.9, 0-14)%, which compared with an actual mean loss of function of 6.8 (5.1, +4 to -16)%. Thus the mean (SD, range) difference between the predicted and actual loss of renal function was -2.1 (3.2, +4 to -8)%.


CONCLUSIONS
DMSA scintigraphy provides an accurate assessment of the differential renal function between upper and lower moieties in a duplex system. The decision to proceed to lower moiety heminephroureterectomy can be logically based on the information gained from DMSA scintigraphy.
Carter
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C
Department of Paediatric Urology, The Wessex Centre for Paediatric Surgery, Southampton University Hospitals NHS Trust, UK.
Malone
P
P
Lewington
V
V
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015902:Gamma Cameras; D006801:Humans; D007223:Infant; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D009392:Nephrectomy / Q000379:methods; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D019783:Technetium Tc 99m Dimercaptosuccinic Acid; D014513:Ureter / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery
D019275:Radiopharmaceuticals; D019783:Technetium Tc 99m Dimercaptosuccinic Acid