Diuresis Renography and Morphology in Upper Urinary Tract Obstruction

Lupton, E. W.; Testa, H. J.; O'reilly, P. H.; Gosling, J. A.; Dixon, J. S.; Lawson, Richard; Edwards, E. C.

doi:10.1111/j.1464-410x.1979.tb04236.x

Cited by 34 publications

(15 citation statements)

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“…They furthermore found the predictive value of a posi tive test to be 92% while the corresponding value of a negative test was a little less (82%). A high sensitivity was also reported by Lupton et al [4], In 26 hydronephrotic kidneys they found a nonobstructed diuresis renogram to be correlated with normal renal pelvic mor phology at operation while obstruction at diuresis renog raphy was confirmed histopathologically in all cases. Other studies have also confirmed a high degree of accor dance between diuresis renography and renal pelvic pa thology [5].…”

Section: Discussionsupporting

confidence: 56%

Sensitivity of¹³¹I-Hippuran Diuresis Renography and Pressure Flow Study (Whitaker Test) in Upper Urinary Tract Obstruction

Jakobsen

Nordling²,

Munck³

et al. 1988

Urol Int

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Diuresis renography and pressure flow studies were performed in 14 patients with unilateral hydronephrosis. Based upon the results of intravenous pyelography, typical symptomatology, and the outcome of surgical treatment, all patients were found to have upper urinary tract obstruction. It was therefore possible to calculate the sensitivity of the two tests. Obstruction was found at the pressure flow studies in 7 of 14 patients (50%), while an obstructive pattern was found at diuresis renography in 12 of 13 patients (92%). Due to a very low glomerular filtration rate, diuresis renography was equivocal in 1 case. Based upon these results, diuresis renography seems to be superior to pressure flow studies in cases with upper urinary tract obstruction.

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Section: Discussionsupporting

confidence: 56%

Sensitivity of¹³¹I-Hippuran Diuresis Renography and Pressure Flow Study (Whitaker Test) in Upper Urinary Tract Obstruction

Jakobsen

Nordling²,

Munck³

et al. 1988

Urol Int

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“…At about the same time, Whitaker introduced the antegrade pressure flow study [32] to diagnose obstruction. Studies comparing these two techniques were published in the following years, showing sometimes excellent and sometimes poor correlation [33][34][35][36][37][38]. Since then, the refinement of diuretic renography and new techniques such as ultrasonography and color Doppler studies limit the use of the Whitaker test to patients with extremely dilated upper urinary tracts in which renal function is poor and in selected cases in which the results of diuretic renography are equivocal or when nephrostomy tube is already in place [31].…”

Section: Diagnosis Of Obstructionmentioning

confidence: 99%

Advances in radionuclide evaluation of urinary tract obstruction

Dubovsky

Russell

1998

Abdom Imaging

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“…The interpretation of the underlying cause of Type Illb curves has been the source of some discussion. The moderate rate of washout which differentiates this diuretic response from the washout achieved in the Type Ilia curve has generally been classified as due to a partially obstructed collecting system (Lupton et al, 1979) although some workers have attributed it to a dilated collecting system (Britton & Maisey, 1983). The rate of clearance of activity from a reservoir will be proportional to the rate of flow through it, but inversely proportional to its volume.…”

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confidence: 98%

The interpretation of renogram curves from the dilated renal tract

Keir¹,

Lee²

1985

BJR

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Diuretic renography is a valuable diagnostic tool in the evaluation of the dilated upper urinary tract. Renogram curves which show an obstructed pattern can be subjected to an increased flow rate as a consequence of the IV administration of a diuretic. A curve showing a rapid washout in response to the diuretic is classified as Type Ilia while one exhibiting a more moderate response is classified Type Illb (O'Reilly et al, 1978). The interpretation of the underlying cause of Type Illb curves has been the source of some discussion. The moderate rate of washout which differentiates this diuretic response from the washout achieved in the Type Ilia curve has generally been classified as due to a partially obstructed collecting system (Lupton et al, 1979) although some workers have attributed it to a dilated collecting system (Britton & Maisey, 1983). The rate of clearance of activity from a reservoir will be proportional to the rate of flow through it, but inversely proportional to its volume. Thus we might expect the volume of a pelvicalyceal system to be a significant factor in determining the slope of the washout phase in addition to the flow rate through it. We have examined this supposition by measuring washout slopes from the renogram and renal pelvis areas seen on intravenous urogram (IVU) in a group of paediatric patients who had been referred for diuretic renography as a result of the findings on the IVU. METHODS AND RESULTSThe analysis was performed on all those patients examined in a two-year period who had both kidneys showing a Type III pattern. Hence all patients had failed to wash out satisfactorily before the administration of the diuretic. A film was selected from the IVU (standard geometry and weight-related dose) which showed maximal filling of the collecting system. The areas of the renal pelves and calyces were measured using an Apple II microcomputer and graphics tablet. Radioisotope renography was carried out in the conventional manner after injecting a weight-related dose of 1-123 Hippuran (1 MBq/kg) and employing a Technicare Sigma 410 gamma camera and associated image processor. A diuretic (frusemide) was employed where necessary (0.25 mg/kg body weight) and a monoexponential function fitted to the washout phase of the renogram curves starting 3-5 minutes from the point of administration of the diuretic and terminating at the end of the study (20 minutes from the diuretic administration) or when the curve reached background level. In this way it was possible to estimate the ratio of collecting system volumes for the left and right kidneys of a given patient from the IVU and measure the ratio of washout rates for the same patient from the diuretic portion of the renogram.By only using patients who had both kidneys showing a Type III pattern, the comparison of washout rate was made with both kidneys under the same conditions of diuresis, assuming both responded equally to the diuretic. The results are plotted in Fig. 1. The distinction between Type Ilia or Type Illb was made on the basis of t...

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Diuresis Renography and Morphology in Upper Urinary Tract Obstruction

Cited by 34 publications

References 5 publications

Sensitivity of¹³¹I-Hippuran Diuresis Renography and Pressure Flow Study (Whitaker Test) in Upper Urinary Tract Obstruction

Sensitivity of¹³¹I-Hippuran Diuresis Renography and Pressure Flow Study (Whitaker Test) in Upper Urinary Tract Obstruction

Advances in radionuclide evaluation of urinary tract obstruction

The interpretation of renogram curves from the dilated renal tract

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Diuresis Renography and Morphology in Upper Urinary Tract Obstruction

Cited by 34 publications

References 5 publications

Sensitivity of131I-Hippuran Diuresis Renography and Pressure Flow Study (Whitaker Test) in Upper Urinary Tract Obstruction

Sensitivity of131I-Hippuran Diuresis Renography and Pressure Flow Study (Whitaker Test) in Upper Urinary Tract Obstruction

Advances in radionuclide evaluation of urinary tract obstruction

The interpretation of renogram curves from the dilated renal tract

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Product

Resources

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Sensitivity of¹³¹I-Hippuran Diuresis Renography and Pressure Flow Study (Whitaker Test) in Upper Urinary Tract Obstruction

Sensitivity of¹³¹I-Hippuran Diuresis Renography and Pressure Flow Study (Whitaker Test) in Upper Urinary Tract Obstruction