Cortical Scar

What is a cortical scar? This is the first question you might want to ask after reading the topic, right? Then, Let me give you a brief definition: “Cortical Scar defined as a defect in the NRF normal reniform outline.” 

A focal or circuitous area of the reduced grasp of the radionuclide with preservation of the normal reniform outline(NRF) is known as a photon deficient area.


Kidney scarring is something that can be found in imaging studies like on CT scan or more specific scan called renal scan a look at your kidney and scarring in the kidney usually due to infections a lot of times it’s something that we see in childhood repeated urinary tract infections that go up into kidneys, can potentially cause a bad kidney infection called pyelonephritis and that if it occurs repeatedly can lead to kidney scarring and sometimes even a decline in kidney function and then of course scarring can also be caused by prior kidney surgeries such as for the removal of a tumor or a stone.

Cortical scarring is termed glomerulosclerosis. This term is used to describe the scarring of the kidney’s tiny blood vessels, the glomeruli, and the functional units in the kidney that filter urea from the blood.

Now, let’s understand what DMSA is; it is a very essential tracer for detecting the renal parenchyma, and it is particularly very useful for the evolution of renal cortical scarring.

A person with recurrent urinary tract infection, especially in the setting of vesical – ureteral reflux, is at the risk of renal cortical scarring and reflux nephropathy.

In some cases, excessive scarring may impact all renal functions.

The thing one should always remember is that patients should not be checked based on their recent urinary test because it may be a chance that pyelonephritis can mimic renal cortical scarring on a DMSA scan. Differential renal function can be calculated by geometric means on the planar imaging, which takes into account the relative depths of the kidney to correct the amount of the counts which are reaching the gamma camera.



Scarring is the non–specific response of the kidney to injury. It occurs during the healing process after damage to living tissue and cells. Scars are a not-so-perfect process for damaged tissues to heal. It usually doesn’t cause any pain. If the scarring is extensive it can lead to a malfunction of an organ(on rare occasions).

The occurrence in the kidney is due to infections within the kidney tissues. Usually, this occurs from a very common- urinary tract infection. And there would rarely be any related pain or any other symptoms.


People think that they haven’t had scarring but the thing is ultrasound, CAT scan, and MRI that are done on imaging the kidney is actually for detecting kidney scarring.

Getting on the causes- blood clot, yes because it prevents oxygen flow in the kidney. This will lead to scars and damaged tissues.

Other causes are:-

– High BP

– Trauma 

– Anxiety

– Infection or viruses

– Glomerulonephritis

– Drug-induced injury

-Chemical injury

– Ureter Blockage

– Blockage of blood vessel


You can be born with this abnormality. It is not specific to any particular disease. 



For Treatments of cortical scarring, your healthcare provides the best treatment based on

  1. Your age.
  2. Your present health records and medical history.
  3. Are you perfectly healthy or disease-free or not?
  4. Your tolerance level determines how well you can handle specific medicines, the procedure of treatment, and also certain therapies.
  5. And lastly, how long it is going to last.
  6. Your opinions and preferences as they matter as well.

Treatment aims to prevent further damage and avoid dialysis. The best treatment for cortical scar depends on what caused the scarring. The cause of the cortical scar is determined by a kidney biopsy.

Treatments are as follows:

  • Medicines For Immune System. It’s simply how the immune system works, it makes antibodies right? So, these medicines will block the body’s immune system which prevents the body from making antibodies that may attack the glomerulus.
  • Process of Dialysis. In this treatment, if the kidneys have stopped working dialysis is used to remove wastes and excess fluid from the blood. Yes, it acts as an artificial kidney.
  • A Kidney transplant. In this procedure, your diseased kidney gets replaced with a healthy one from a donor.
  • Blood pressure-lowering medicines
  • Diet changes
  • Blocking stopping medicines.
  • Downsize chemical injury.
  • Trauma-reducing medicines.


Even with treatment, complications may also develop. You might get kidney failure. This requires treatments mentioned above I.e. Dialysis or even a kidney transplant.


Know the “Red flag” and contact your healthcare provider, it’s when you discover new symptoms or your previous one got worse.


  1. Always ask your doctor about what your new medication is and why it is necessary, and also know what the side effects are.
  2. Know why a pest or procedure is recommended and what the results could mean.
  3. Know what to expect if you do not take the medicines or have the test procedure.
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