방사선의학 웹진

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Abstract

OBJECTIVE:
We aimed to determine the factors contributing toward diffusely increased renal uptake on bone scintigraphy using technetium-99m (Tc-99m) diphosphono-propanedicarboxylic acid (DPD) in patients with end-stage renal disease.

PATIENTS AND METHODS:
One-hundred and forty-three bone scintigraphies, performed between June 2007 and July 2013, in 135 patientswith chronic kidney disease were analyzed retrospectively, including 22 bone scintigraphies (15 patients; eight women; seven men) with glomerular filtration rates less than 15 ml/min/1.73 m. Patients with nephrocalcinosis were excluded. The clinical records of medication and underlying disease were reviewed retrospectively. The presence of renal artery calcification was visually estimated and the Hounsfield unit (HU) of renal parenchyma was measured by abdominal and pelvic nonenhanced computed tomography.

RESULTS:
Two patients underwent peritoneal dialysis and 13 underwent hemodynamic dialysis. Diffusely increased renal Tc-99m DPD uptake was observed on 15 of 22 (68%) bone scintigraphy images. Laboratory test results were not significantly different between the patients with or without increased renal uptake. A history of inflammatory conditions or antibiotic administration did not correlate with kidney visualization. The significant factor for diffuse renal tracer uptake on multivariate analysis was renal artery calcification (odds ratio: 18.42; 95% confidence interval: 2.01-79.43; P<0.001). The mean HU values were significantly higher in patients with diffuse renal tracer uptake(P=0.04) and renal artery calcification (P=0.02).

CONCLUSION:
Small renal arteriolar calcification and a higher HU value of renal parenchyma could be associated with diffusely increasedrenal Tc-99m DPD uptake in patients with end-stage renal disease.

Author information

Kim K1, Kim SJ, Song SH, Kim IJ, Pak K, Kim SJ, Shin S, Kim BS.
1
aDepartment of Nuclear Medicine and Biomedical Research Institute bDepartment of Internal Medicine, Pusan National University Hospital, Busan cDepartment of Nuclear Medicine and Research Institute for Convergence of Biomedical Science and Technology, Yangsan Pusan National University Hospital, Yangsan, Republic of Korea.