Int J Clin Pract. 2021 Sep 6:e14810. doi: 10.1111/ijcp.14810. Online ahead of print.
ABSTRACT
BACKGROUND: Technetium-99m-dimercapto succinic acid (Tc-99m DMSA) scintigraphy is a commonly used imaging modality in children with urological abnormalities. The radiopharmaceuticals, which have the effects of ionizing radiation, are used in this method. This study aimed to investigate the impact of the Tc-99m DMSA scan on renal oxidative stress and mononuclear leukocyte (MNL) DNA damage.
METHODS: Children, who were followed up by pediatric nephrology at Bezmialem Vakif University and underwent Tc-99m DMSA scintigraphy between April 2015 and January 2016 with the indication of detection of renal scars, were included in this study. The exclusion criteria were nephrolithiasis, history of premature birth, and recent urinary tract infection six months prior to scintigraphy or antibiotic use in the last one month. Three ml heparinized blood samples were obtained just before, immediately after, and one week after the scintigraphy. MNL DNA damage, total antioxidant status (TAS), and total oxidant status (TOS) were measured in the blood samples. The oxidative stress index (OSI) was calculated. Spot urine samples were obtained from each patient before and within three days after performing the scintigraphy. TAS/Creatinine (TAS/Cr), TOS/Creatinine (TOS/Cr), and N-acetyl-glucosaminidase/creatinine (NAG/Cr) levels were measured in the urine samples.
RESULTS: Twenty-seven children were evaluated. The values between TAS, TOS and OSI levels in serum samples at baseline, immediately after, and one week after the scintigraphy (p=0.105, p=0.913, and p=0.721, respectively) showed no statistically significant difference. The levels of TAS/Cr, TOS/Cr, NAG/Cr ratios, and OSI, which were evaluated from urine samples before and within three days after the scintigraphy scan were also similar (p=0.391, p=0.543, p=0.819 and p=0.179 respectively). The levels of DNA damage only increased following scintigraphy scan and decreased a week later (p<0.05).
CONCLUSIONS: The effect of Tc-99m DMSA scintigraphy is insufficient to create oxidative damage, but it can cause DNA damage via the direct impact of ionizing radiation which can be repaired again in a short time.
PMID:34487588 | DOI:10.1111/ijcp.14810
