title: Diuretic MAG3 scintirenography in children with HIV nephropathy: diffuse parenchymal dysfunction.
abstract: HIV nephropathy (HIVN) is prevalent in 15%-56% of HIV-infected children and induces mild to severe progressive nephropathy.
  
  
  METHODS
  A total of 33 renal diuretic scintirenographic studies with 99mTc-mercaptoacetyltriglycine (MAG3) were reviewed and analyzed from 23 HIV pediatric patients, 21 of whom had HIVN with varying degrees of renal impairment. Results were compared with 10 studies of control patients of matching ages. Visual interpretation of images and renograms as well as semiquantitative analyses were performed. Variables compared were size of kidneys, time of peak and one-half peak activities, residual (or retained) cortical activity at 20 min, ratio of cortical activity at 2.5-20 min, and ratio of kidney activity to kidney plus background activity at 2 min. The results of MAG3 renal studies were also compared with laboratory data pertaining to creatinine clearance in all patients and with sonography in 17 patients.
  
  
  RESULTS
  In most patients with HIVN (18/21), the kidneys were larger than normal, with a diffuse parenchymal dysfunction (decreased uptake, slow processing, and increased retention of activity) and flat renograms, findings similar to those observed in other diffuse parenchymal diseases. In all patients with HIVN, semiquantitative analysis (paired t test) showed statistically significant differences from control patients for all variables. On ANOVA, a statistically significant correlation was found between most scintigraphic parameters and the severity of renal impairment. Of the 17 concurrent sonographic studies in HIVN patients, 7 showed no abnormalities, whereas the results of scintigraphy were abnormal.
  
  
  CONCLUSIONS
  Diuretic MAG3 scintirenography shows nonspecific diffuse parenchymal dysfunction in pediatric patients with HIVN. Such dysfunction may provide corroborative evidence of HIVN and should be recognized when the test is performed for standard indications. Further work is necessary to prove that the test has indeed the high sensitivity and good correlation with the seventy of HIVN suggested in this population; the test may be useful to follow up the progression of disease and the effect of treatment.
authors.affiliation: Department of Radiology, University of Miami School of Medicine and Jackson Memorial Hospital, Florida 33101, USA.
authors.forename: G N
authors.initials: GN
authors.lastname: Sfakianakis
authors.forename: A J
authors.initials: AJ
authors.lastname: Carmona
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: J
authors.initials: J
authors.lastname: Strauss
authors.forename: M F
authors.initials: MF
authors.lastname: Georgiou
authors.forename: G E
authors.initials: GE
authors.lastname: Zilleruelo
authors.forename: C A
authors.initials: CA
authors.lastname: Abitbol
authors.forename: B S
authors.initials: BS
authors.lastname: Montane
mesh_terms: D016263:AIDS-Associated Nephropathy / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004232:Diuretics; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011866:Radioisotope Renography; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D017263:Technetium Tc 99m Mertiatide
chemical_list: D004232:Diuretics; D019275:Radiopharmaceuticals; D017263:Technetium Tc 99m Mertiatide