Comparison of Three Different Diuretic Renal Scintigraphy Protocols in Patients With Dilated Upper Urinary Tracts

Türkölmez, Şeyda; Atasever, Tamer; Türkölmez, Kadír; Göğüş, Orhan

doi:10.1097/01.rlu.0000113852.57445.23

Cited by 29 publications

(21 citation statements)

References 15 publications

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“…The diuretic may be administered after the renogram phase of the TAC (20 min, F+20) 42,43 ; the radiopharmaceutical and diuretic may be injected simultaneously (F+0) 44 or the diuretic may be administered 15 min before the injection of the radiopharmaceutical (F−15) 45 . Although both equivalent and inaccurate results have been reported when different methods were compared, 46,47 all three protocols are considered acceptable according to consensus reports 25,48 . Time of furosemide injection in this study (4.5 min after injection of the radiopharmaceutical) was chosen based on a protocol established in dogs 24 .…”

Section: Discussionmentioning

confidence: 92%

Diuretic Renal Scintigraphy in Normal Cats

Hecht

Lane

Daniel

et al. 2008

Vet Radiology Ultrasound

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The purpose of this study was to develop a protocol for diuretic renal scintigraphy (renography) in cats and describe normal findings. 99mTc-DTPA renal scintigraphy was performed twice in 10 healthy cats. Furosemide or saline were injected 4.5 min after radiopharmaceutical administration for the diuretic or control scan, respectively. A dynamic acquisition was performed for 8 min. The following parameters were evaluated: (1) global and individual glomerular filtration rate (GFR); (2) shape of the time-activity curve (TAC); (3) time of peak (TOP); (4) individual kidney excretion half-time (T1/2) of the radiopharmaceutical; (5) percentage of maximum activity measured at the end of the study. Global GFR in the control studies (2.79 +/- 0.83 ml/min/kg, mean +/- SD) did not differ significantly from the diuretic scans (2.34 +/- 0.51 ml/min/kg). The shape of most (16/ 20) TAC of diuretic renograms was similar to those of control renograms. The TOP of the diuretic renogram curves was 3.06 +/- 0.58 min, and did not differ from that of the control scans (3.01 +/- 0.61 min). T1/2 of the diuretic renograms was significantly shorter (5.15 +/- 0.83 min) than that of the control renograms (6.31 +/- 1.50 min). A significantly lower percentage of maximum activity was present at the end of the study in diuretic renograms (median: 47.25%; range: 33.60-59.60%) compared with control renograms (63.40%; 30.00-69.40%). Diuretic renal scintigraphy is a noninvasive and fast procedure to perform in cats. The applicability of this technique needs to be investigated in patients with significantly impaired renal function and obstructive uropathies.

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Section: Discussionmentioning

confidence: 92%

Diuretic Renal Scintigraphy in Normal Cats

Hecht

Lane

Daniel

et al. 2008

Vet Radiology Ultrasound

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“…The timing of furosemide injection has significant impact on the interpretation of a renogram as obstructive or nonobstructive. Equivalent and inaccurate results have been reported comparing different protocols 41,42 . However, all three protocols are currently considered acceptable according to consensus reports 22,24 .…”

Section: Discussionmentioning

confidence: 99%

Diuretic Renal Scintigraphy in Normal Dogs

Hecht

Daniel

Mitchell

2006

Vet Radiology Ultrasound

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Diuretic renal scintigraphy is commonly used in human medicine to differentiate obstructive from nonobstructive pyelectasia. In order to determine normal parameters, 99mTc-DTPA renal scintigraphy was performed twice in 20 healthy adult Mongrel dogs. Each dog was injected with either 3.0 mg/kg furosemide or an equivalent volume of saline 4.5 min following injection of the radiopharmaceutical. The following parameters were evaluated: (1) global and individual glomerular filtration rate (GFR); (2) time of peak (TOP) of the time-activity curve (TAC); (3) shape of the TAC; (4) individual kidney excretion half-time (T1/2); (5) proportion of maximum activity measured at end of study (8 min); (6) time of onset; and (7) duration of the effect of the diuretic. Most TAC in the diuretic renography group showed a steep drop in the curve following administration of the diuretic compared with a gradual slope in the saline control group. There was a statistically significant difference in T1/2 between the control renograms (median 10.25 min, range 4.41-18.07 min) and the diuretic renograms (median 4.16 min, range 3.62-5.90 min). There was a statistically significant difference in percentage maximum activity between the control renograms (median 65.25%, range 48.27-93.68%) and the diuretic renograms (median 48.54%, range 35.64-58.76%). Median time of onset of the diuretic effect was 1.10 min (0.20-2.40 min), and median duration was 0.83 min (0.30-2.35 min).

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“…Moreover, a functional obstruction can also be differentiated from an anatomic cause. 28,29 In our study, three cases which were non-functioning on IVP were subjected to renal scan. Dalrymple et al (1998) used Unenhanced Computerized Tomography (CT) for the management of acute flank pain and found 95% sensitivity, 98% specificity and 97% accuracy in ureteric stones.…”

Section: Discussionmentioning

confidence: 99%

Radiological Investigations, Biochemical Renal Function Tests and the Changes After Surgery in Renal Calculus Obstructive Uropathy

Gupta¹,

Saini²,

Gupta³

et al. 2016

jemds

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Urolithiasis has affected the mankind for long years. These stones cause progressive renal impairment. These patients usually present with characteristic loin pain, vomiting, and sometimes fever. Patients may also be asymptomatic at times. Urinary stones can be classified on the basis of their size, location, X-ray characteristics, aetiology, composition (Mineralogy) and risk groups for recurrent stone formation. AIMS AND OBJECTIVESTo evaluate the Preoperative and postoperative radiological and biochemical changes in renal calculus obstructive uropathy in patients with cortical thickness of minimum 4mm. MATERIAL AND METHODSAll patients who were admitted in Department of Surgery, Rama Medical College Hospital and Research Centre, Kanpur, UP with diagnosis of obstructive uropathy due to stone disease and operated upon were included in this study. RESULTSAfter 1 month and 3 months the relief in obstruction was studied by repeating the tests. It was found that urea, creatinine levels took about 3 months to get normalized. USG and IVP at 3 months showed complete normalization of hydronephrosis, however, at one month few cases still had hydronephrosis. CONCLUSIONUrea, creatinine levels along with USG and IVP form the basis of detection and management of obstructive uropathy. CT scan has a definitive role in few cases where urea creatinine levels are on higher side. Renal scan is mandatory in the cases of delayed/nonfunctioning on IVP. Nephrectomy should not be done without assessment of renal function (%) on renal scan. After definitive management of relief of obstruction by various methods, it takes about three months for normalization of kidney function. KEYWORDSUrea, Creatinine, Ultrasonography, Intravenous Pyelography, Renal Scan, Renal Stone. HOW TO CITE THIS ARTICLE:Gupta M, Saini P, Gupta P, et al. Radiological investigations, biochemical renal function tests and the changes after surgery in renal calculus obstructive uropathy.

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Comparison of Three Different Diuretic Renal Scintigraphy Protocols in Patients With Dilated Upper Urinary Tracts

Cited by 29 publications

References 15 publications

Diuretic Renal Scintigraphy in Normal Cats

Diuretic Renal Scintigraphy in Normal Cats

Diuretic Renal Scintigraphy in Normal Dogs

Radiological Investigations, Biochemical Renal Function Tests and the Changes After Surgery in Renal Calculus Obstructive Uropathy

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