Color Doppler sonographic determination of renal blood flow in healthy children.

Abstract

he determination of renal blood flow is of great interest in many clinical settings that alter renal function, such as acute or chronic renal failure, inflammation, scarring, swelling, trauma, operations, and other conditions. Renal perfusion is the necessary prerequisite of renal function. Depression of renal perfusion will lead to loss of function when the functional reserve of the kidney has become exhausted. Until now pediatricians have been dependent on relatively insensitive indicators of renal function, such as creatinine or urea concentrations, or has had to carry out time-consuming or expensive procedures like tests of clearances or nuclear medical investigations. A bedside method for evaluating renal perfusion is therefore desirable.Color Doppler sonography offers the possibility of measuring renal perfusion parameters even in small or chronically ill children. Only semiquantitative techniques have been established. The most commonly used are RI and PI. These indices reflect relationships of blood flow velocities at various points in one cardiac cycle but do not give any information about the volume of blood passing through the kidneys. They were the first parameters to describe the spectral analysis of the renal Doppler sonographic The volumetric measurement of the real renal perfusion is of interest in many clinical situations. It promises better understanding of renal function and development in healthy children and in children with acute or chronic renal failure, inflammation of any type, scarring, swelling, trauma, operations, and other conditions. Until now only scintigraphic techniques allowed measurement of the renal plasma flow in clinical practice. With color Doppler sonography all relevant data to calculate the volume of blood that passes through the kidney in a certain time can be measured. The aim of this paper is to investigate the utility of color Doppler sonography in describing renal perfusion in 63 healthy children in four separate age groups. It can be shown that the perfusion volume related to the body surface area is constant throughout childhood. Its mean value is 383 ml/min ⋅ m 2 .The results of the new technique of color Doppler sonographic volumetric determination of renal blood flow are then compared in 21 pediatric patients with the results of scintigraphic determination of the renal perfusion by 123 I-hippurate clearance. This way a significant correlation of both methods can be demonstrated.

Changes of renal flow volume in the hemolytic-uremic syndrome - color Doppler sonographic investigations

“…We demonstrated in previous investigations that the BSARVP can be measured reliably in healthy children [13] by CDUS. A significant correlation between the 123 Ihippurate clearance (r=0.70, P=0.00) and the BSA-related flow volume in children was demonstrated.…”

“…In a healthy pediatric population we demonstrated previously the use of quantitative volume perfusion measurements [13]. This new technique of measurement of the volume flow may provide insights into damage of the renal vasculature in HUS.…”

Evaluating and managing neonatal acute renal failure in a resource-poor setting

“…[10] [11] The colour Doppler sonographic machines which provide better information about renal blood flow are also not routinely used while most centres provide ultrasonographic scanning services with less informative scintigraphic methods 12 . Similarly, contrast studies useful in delineating urogenital malformations and assessing renal excretory functions are usually inaccessible even when indicated.…”

A New Method of Color Doppler Perfusion Measurement via Dynamic Sonographic Signal Quantification in Renal Parenchyma

“…Until now perfusion measurements in the main feeding arteries are possible [10]. Such measurements can be used to evaluate renal function [11].…”