MPI DMSA KIDNEY REAGENT
Clinical safety rating: caution
Comprehensive clinical and safety monograph for MPI DMSA KIDNEY REAGENT (MPI DMSA KIDNEY REAGENT).
DMSA (dimercaptosuccinic acid) labeled with technetium-99m binds to renal cortex, particularly proximal tubular cells, allowing scintigraphic imaging of functional renal parenchyma. Uptake correlates with renal blood flow and tubular function.
| Metabolism | Not metabolized; excreted primarily via glomerular filtration and tubular secretion. |
| Excretion | Renal: ~50% excreted unchanged in urine within 24 hours; remaining fraction retained in renal tubular cells with gradual release over weeks. |
| Half-life | Initial whole-body half-life of dimer captosuccinic acid (DMSA) is 1.1 hours; terminal elimination half-life for cortical retention is 56 days, reflecting prolonged renal tubular uptake. |
| Protein binding | ~90% bound to plasma proteins, primarily albumin. |
| Volume of Distribution | 0.28 L/kg, indicating distribution primarily into extracellular fluid and renal cortex. |
| Bioavailability | Not applicable; administered intravenously only. |
| Onset of Action | Renal cortical uptake begins 1 hour after intravenous injection; optimal imaging at 2–3 hours post-dose. |
| Duration of Action | Diagnostic imaging quality maintained for 2–4 hours post-injection; renal cortical activity persists for days but clinically appropriate images are obtained within 6 hours. |
Adults: 74-185 MBq (2-5 mCi) intravenously, single dose for renal imaging.
| Dosage form | INJECTABLE |
| Renal impairment | No dose adjustment required; agent is renally eliminated but used for renal function assessment. |
| Liver impairment | No dose adjustment required per Child-Pugh classification. |
| Pediatric use | Weight-based: 1.85-3.7 MBq/kg (0.05-0.1 mCi/kg) intravenously, minimum 18.5 MBq (0.5 mCi). |
| Geriatric use | No specific dose adjustment; use standard adult dose with caution for impaired renal function. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for MPI DMSA KIDNEY REAGENT (MPI DMSA KIDNEY REAGENT).
| Breastfeeding | Tc-99m DMSA is excreted in breast milk in trace amounts. M/P ratio not established. Interrupt breastfeeding for at least 4 hours post-injection and discard expressed milk during this period. |
| Teratogenic Risk | Technetium Tc 99m succimer (DMSA) is a radiopharmaceutical. Fetal radiation exposure is dose-dependent; risk of teratogenicity is low with diagnostic activities (<5 mGy). First trimester: theoretical risk of deterministic effects; avoid unless essential. Second/third trimester: low risk, but benefit must outweigh radiation hazard. |
■ FDA Black Box Warning
None.
| Serious Effects |
["Known hypersensitivity to DMSA or any component","Pregnancy (relative, if alternative imaging available)"]
| Precautions | ["Risk of hypersensitivity reactions including anaphylaxis","Use caution in patients with impaired renal function as radiation exposure may be prolonged","Pregnancy and lactation: consider risks versus benefits","Ensure adequate hydration to reduce radiation dose to bladder"] |
Loading safety data…
| Fetal Monitoring |
| Maternal: none specific. Fetal: Consider fetal radiation dose estimation; use lowest effective activity. No routine fetal monitoring required after standard diagnostic use. |
| Fertility Effects | No known effects on fertility from diagnostic Tc-99m DMSA. Radiation exposure to gonads is negligible at typical activities. |