Child silhouette with glowing kidney, question mark

Kidney Scan After a Child's Infection: Scar or Just Healing?

Soraya Malik in Health & Wellness December 2025 • 5 min read.

"Understanding DMSA Scans and Follow-Up Care After Pediatric Pyelonephritis"

As a parent, few things are more unsettling than a health scare involving your child. When a child is diagnosed with pyelonephritis, a type of kidney infection, the road to recovery can feel fraught with uncertainty. A common follow-up involves a DMSA (Dimercaptosuccinic acid) renal scan, an imaging test used to assess kidney health. However, what happens when that scan, performed months after the initial infection, reveals a lesion or abnormality?

The standard interpretation is that such lesions indicate permanent scarring, raising concerns about potential long-term complications like hypertension or kidney dysfunction. This is understandably alarming for parents. However, recent research suggests a more nuanced picture. A study published in the journal Revista Médica de Chile sheds light on the evolution of these lesions, questioning the assumption that they always represent irreversible damage.

This article will delve into the findings of this research, offering a clearer understanding of DMSA scans, the significance of lesions detected after pyelonephritis, and what this means for your child's follow-up care. We'll explore why a 'wait-and-see' approach might be more appropriate than immediately assuming the worst, providing you with the information needed to navigate this challenging situation with confidence.

DMSA Scans: What Do They Really Tell Us?

Child silhouette with glowing kidney, question mark

A DMSA scan is a type of nuclear medicine imaging used to evaluate the structure and function of the kidneys. It's particularly useful in children who have experienced pyelonephritis, as it can detect subtle damage to the kidney tissue (parenchyma). The scan involves injecting a small amount of a radioactive tracer, DMSA, which is then absorbed by the kidney cells. A special camera detects the tracer, creating images of the kidneys. Areas with reduced tracer uptake may indicate damage or scarring.

The traditional interpretation is that any abnormality seen on a DMSA scan performed six months or more after a pyelonephritis episode represents a permanent scar. This is because it was believed that any reversible inflammation or swelling would have resolved by that point. However, the Revista Médica de Chile study challenges this assumption.

The Study's Key Findings: The researchers followed 85 children who had experienced acute pyelonephritis, performing DMSA scans during the acute phase (within 7 days of fever onset) and then again 5-7 months later. If lesions persisted, a third scan was performed at 10-13 months.
Surprising Results: The study found that while 31% of the children had abnormal DMSA scans on the early follow-up (5-7 months), a significant portion of these lesions resolved on the later scan (10-13 months). Specifically, 21% of the kidney units that showed lesions at the early follow-up normalized by the late follow-up.
Implications for Parents: This suggests that a lesion seen on a DMSA scan 6 months after pyelonephritis doesn't automatically equate to a permanent scar. In some cases, the kidney is still healing and the lesion may resolve over time.

This is not to say that all lesions will disappear. The study found that 25% of the children still had abnormal scans at the final follow-up, indicating some degree of persistent sequelae. However, the key takeaway is that a more cautious approach is warranted before labeling a lesion as a permanent scar.

What This Means for Your Child's Care: A More Balanced Approach

The Revista Médica de Chile study highlights the importance of a nuanced approach to interpreting DMSA scans in children after pyelonephritis. While a lesion detected at the 6-month mark should not be dismissed, it also shouldn't be automatically considered a permanent scar. Instead, a period of observation and a later follow-up scan may be warranted.

This 'wait-and-see' approach can alleviate parental anxiety and potentially avoid unnecessary interventions. It's crucial to maintain regular check-ups with your child's pediatrician or nephrologist. They can monitor your child's blood pressure, urine, and kidney function, and determine the appropriate timing for a repeat DMSA scan. Your doctor will consider other factors, such as the severity of the initial infection, the presence of vesicoureteral reflux (VUR), and any recurrent urinary tract infections, to guide their decision-making.

Ultimately, the goal is to identify children who are truly at risk for long-term kidney complications and provide them with the necessary care. By understanding the evolving nature of kidney lesions after pyelonephritis, and by working closely with your child's healthcare team, you can ensure that your child receives the best possible care and support.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.4067/s0034-98872012000600008, Alternate LINK

Title: Una Lesión En El Cintigrama Renal Dmsa 6 Meses Post Fase Aguda De Una Pielonefritis Representa Siempre Una Cicatriz: Un Debate Abierto

Subject: General Medicine

Journal: Revista médica de Chile

Publisher: SciELO Agencia Nacional de Investigacion y Desarrollo (ANID)

Authors: Gilda Donoso, Elizabeth Lagos, Pía Rosati, Pilar Hevia, Karen Cuevas, Gabriel Lobo, Andrés Pérez, César Jiménez, Daniela Gutiérrez

Published: 2012-06-01

Everything You Need To Know

What exactly is a DMSA scan, and what does it do?

A DMSA (Dimercaptosuccinic acid) scan is a nuclear medicine imaging technique used to evaluate the structure and function of the kidneys. It involves injecting a small amount of a radioactive tracer, DMSA, which is absorbed by kidney cells. A special camera then detects the tracer, creating images that can reveal areas of damage or scarring in the kidney tissue (parenchyma). This is a crucial tool for assessing kidney health in children, particularly after a kidney infection like pyelonephritis, because it can detect subtle damage that other imaging techniques might miss. It helps doctors understand the extent of the damage caused by the infection and can guide further treatment or monitoring.

What is pyelonephritis, and why is it relevant to this discussion?

Pyelonephritis is a type of kidney infection. When a child is diagnosed with pyelonephritis, the standard medical practice often involves follow-up care, including a DMSA scan. The significance of pyelonephritis in the context of the article is that it's the condition that often leads to the use of DMSA scans. The concern arises because of the potential for permanent kidney damage and complications such as hypertension or kidney dysfunction as a result of the infection.

What is the significance of the Revista Médica de Chile study?

The *Revista Médica de Chile* study is significant because it challenges the traditional interpretation of DMSA scan results after pyelonephritis. The study found that a lesion seen on a DMSA scan 6 months after pyelonephritis doesn't automatically equate to a permanent scar. Some lesions resolved over time. This information is important for parents because it suggests that a 'wait-and-see' approach may be more appropriate than immediately assuming the worst. This could potentially reduce unnecessary worry and potentially invasive interventions.

What are the implications of the Revista Médica de Chile study findings for children's care?

The study in *Revista Médica de Chile* has important implications for the care of children with pyelonephritis. The study found that a significant portion of lesions seen on a DMSA scan, performed 5-7 months after pyelonephritis, resolved on a later scan (10-13 months). This suggests that not all abnormalities seen on the scan are permanent scars. Therefore, a more cautious approach is warranted before labeling a lesion as a permanent scar. The results suggest that a period of observation and a later follow-up scan may be beneficial before making definitive conclusions about the extent of kidney damage.

If a DMSA scan shows a lesion six months after a kidney infection, does that automatically mean there's a permanent scar?

The key takeaway is that a lesion seen on a DMSA scan performed six months after pyelonephritis doesn't automatically mean there is a permanent scar. The study showed that a significant percentage of these lesions can resolve over time. This impacts the care of children with pyelonephritis by highlighting the importance of a nuanced approach to interpreting DMSA scans. The findings suggest that a period of observation and a follow-up scan may be warranted before making a definitive conclusion about permanent damage. The implications for parents are that they may not need to worry as much if an early scan reveals a lesion. It underscores that the kidney may still be healing.