대한핵의학회지 (1967년~2009년)
대한핵의학회지 1999;33(4)398~7
미세 단백뇨기의 당뇨병 환자에서 99mTc-DMSA 신섭취율은 감소하는가? ( Is the Renal Uptake of 99mTc-DMSA Decreased in Microalbuminuric Diabetic Patient? )
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Author 김성장(Seong Jang Kim),김인주(In Ju Kim),김용기(Yong Ki Kim),
Affiliation
Abstract

Purpose: Diabetic nephropathy is the most common cause of end stage renal disease and the incidence is progressively increasing. The aim of this study was to investigate the differences of 99mTc-DMSA renal uptake among diabetic patients with normoalbuminuria, microalbuminuria and overt proteinuria, and then to determine the clinical usefulness of 99mTc-DMSA in predicting early diabetic nephropathy. Materials and Methods: 99mTc-DMSA scan was performed and a total renal uptake of 99mTc-DMSA was measured in 145 diabetic patients. Patients were divided into 3 groups according to the amount of 24 hour urinary albumin excretion as Group I (normoalbuminuria, 74 cases), Group Ⅱ (microalbuminuria, 39 cases), and Group Ⅲ (overt proteinuria, 32 cases). The differences of 99mTc-DMSA renal uptake among the 3 groups and the correlation between the renal uptake of 99mTc-DMSA and other clinical parameters were analyzed. Results: The total renal uptake of 99mTc-DMSA of Group Ⅱ (40.8±11.0%) was significantly lower than that of Group I (54.4±6.3%, p<0.001). The uptake of Group Ⅲ (27.7±12.0%) was significantly lower than those of both GroupⅠand Group II (p<0.001). 99mTc-DMSA total renal uptakes correlated negatively with serum creatinine level (r=-0.629, p<0.001) and positively correlated with creatinine clearance rate (r=0.702, p<0.001). Conclusion: 99mTc-DMSA total renal uptake of diabetic patients with microalbuminuria was significantly decreased compared with that of patients of normoalbuminuria. Therefore, 99mTc-DMSA scan can be used as a diagnostic study for early detection of the diabetic nephropathy. (Korean J Nucl Med 1999;33:398-404)

Keyword Diabetic nephropathy, Microalbuminuria, Tc-99m DMSA
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