Diagnosis of urine extravasation after renal transplantation

Spigos, D G; Tan, Walter S.; Pavel, DG; Mozes, Martin F.; Jonasson, Olga; Capek, Vlastimil

doi:10.2214/ajr.129.3.409

Cited by 33 publications

(5 citation statements)

References 11 publications

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“…However, this study had a small sample size, and the methodology used for determining this value was different. Graft function in renal transplantation can have a significant impact on the biochemical profile of urinary leaks[ 18 ] and this population differs from our cohort.…”

Section: Discussionmentioning

confidence: 99%

Drain fluid creatinine-to-serum creatinine ratio as an initial test to detect urine leakage following cystectomy

Regmi

Bearrick

Hanna

et al. 2021

Indian Journal of Urology

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Introduction: Urine leak following radical cystectomy is a known complication. Among the various methods to diagnose this, assessment of drain fluid creatinine is a relatively easy procedure. We aimed to ascertain the validity of the drain fluid creatinine-to-serum creatinine ratio (DCSCR) as an initial indicator of urinary leak in patients undergoing radical cystectomy. Methods: We retrospectively identified consecutive patients with documentation of drain fluid creatinine in the postoperative period following cystectomy and urinary diversion at our institution between January 2009 and December 2018. All continent diversions and any patient with a DCSCR >1.5:1 underwent contrast study postoperatively. A diagnosis of urine leak was made following confirmatory imaging. Receiver operative characteristic curves were created, and Youden's index was used to determine the strength and clinical utility of DCSCR as a diagnostic test. Results: Two hundred forty-four of the 340 patients included in the study underwent cystectomy with conduit and 81 underwent neobladder creation. Sixteen out of 340 (4.7%) patients had radiologically confirmed urinary leak. DCSCR was elevated in all ureteric anastomotic leaks and in 1 out of the 7 neobladder-urethral anastomotic (NUA) leaks. The sensitivity and specificity of DCSCR to predict all urinary leaks were 68.8% and 80.9% at 1.12 (area under the curve [AUC] = 0.838), whereas at a value of 1.18 (AUC = 0.876) and with the exclusion of NUA leaks, the sensitivity was 77.8% and specificity was 87.6%. Conclusions: DCSCR is a good preliminary test for identifying patients who need prompt confirmatory testing for localizing urinary leaks. A drain creatinine level just 18% higher than the serum creatinine level can signify a urine leak. This is different from general assumptions of a higher DCSCR.

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Section: Discussionmentioning

confidence: 99%

Drain fluid creatinine-to-serum creatinine ratio as an initial test to detect urine leakage following cystectomy

Regmi

Bearrick

Hanna

et al. 2021

Indian Journal of Urology

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“…der konventionellen Zystogramme, Ausscheidungsurographien und auch des Ultraschalles sogar noch übertroffen (2,23,25). Gerade bei der Suche nach einer postrenalen Ursache wurde früher die szintigraphische Methode bevorzugt (15,20,23 Die Sensitivität für die Abstoßungsreaktion reicht in der Literatur von 75% (11) und 77% (13) über 80% (14) bis zu 100% (4; 13 Patienten). Zusätzlich wurde die Möglichkeit einer gar bis um eine Woche früheren Erkennung der Abstoßungsreaktion als mit den sonstigen zur Verfügung stehenden Methoden hervorgehoben (5).…”

Section: Diskussionunclassified

Zur Wertigkeit der kombinierten computerunterstützten Perfusionsszintigraphie und Renographie bei Oligurie/Anurie von nierentransplantierten Patienten

Miserez¹

1989

Nuklearmedizin

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Combined computer-aided perfusion scintigraphy and renography (computer renography) is used for the differential diagnosis of the etiology of transplant malfunctions in kidney-transplant patients. This article describes semiquantitative computer renography evaluation methods which have been used in 99 examinations of 58 oligo/anuric graft recipients. The accuracy of these methods was confirmed by patho-anatomical and roentgenological diagnosis. From the constellation of qualitative and semiquantitative scintigraphic perfusion, function and excretion parameters it was possible, by means of a flow chart, to draw conclusions regarding the location of the malfunctions (prerenal, renal or postrenal). Using the new methods, all patients could be correctly classified. With respect to more detailed differential diagnosis of renal malfunctions the accuracy was 82%. The comparison between perfusion measurements based on a perfusion index defined with the help of a planimeter on the one hand and an angiography graduation on the other hand, resulted in a correlation coefficient of 0.90 (p < 0.001). As a non-invasive examination which can also be carried out in emergency cases, combined computer-aided perfusion scintigraphy and renography should become part of standard diagnostic procedures for oligo/anuric graft recipients.

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“…More recently, Ultrasound has been used to defme the possible complications. In particular, it has been useful in defining extra-renal collections (Spigos et al, 1977;Phillips er ul, 1976). Although ultrasound remains the appropriate first investigation where such Collections are suspected, in selected cases where the diagnosis remains uncertain, computerized tomography can provide further inportant information.…”

Section: Introductionmentioning

confidence: 99%

Computerized Tomography in the Diagnosis of Complications Following Renal Transplantation

Sage

Pugsley²,

Simmons

1980

Australas Radiol

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Diagnosis of urine extravasation after renal transplantation

Cited by 33 publications

References 11 publications

Drain fluid creatinine-to-serum creatinine ratio as an initial test to detect urine leakage following cystectomy

Drain fluid creatinine-to-serum creatinine ratio as an initial test to detect urine leakage following cystectomy

Zur Wertigkeit der kombinierten computerunterstützten Perfusionsszintigraphie und Renographie bei Oligurie/Anurie von nierentransplantierten Patienten

Computerized Tomography in the Diagnosis of Complications Following Renal Transplantation

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