Diuresis Renography in Equivocal Urinary Tract Obstruction

O'reilly, P. H.; Testa, H. J.; Lawson, Richard; Farrar, David J.; Edwards, E. C.

doi:10.1111/j.1464-410x.1984.tb07170.x

Cited by 38 publications

(45 citation statements)

References 3 publications

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“…At a high urinary flow, an obstruction leads to an increase of intrapyelic pressure and a decrease of ureteral urine flow [1], This physiological concept is the basis of percutaneous pressure flow studies (Whitaker's test) [2] and of the diuresis renography [3,4], Obstruction, when present for more than 24 h, also causes a decrease of the renal blood flow and of the glomerular filtration rate [14], Such abnormalities, together with an increase of sodium tubular absorption, cause a slowing down of parenchymal transit, leading to the hypothesis that the measurement of the parenchymal transit time of a nuclear agent can be useful in the diagnosis of PUO [15].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Diagnosis of Suspected Urinary Tract Obstruction Using a Stimulated Diuresis Test

Meola

Giuliano

Morelli

et al. 1995

Nephron

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The aim of this study was to evaluate whether a stimulated diuresis test associated with ultrasound is able to differentiate pelvic dilation due to atonicity from pelviureteric junction obstruction (PUO). 42 patients (25 f, 17 m) with minimal or moderate renal pelvis dilation revealed by sonography were selected for the test. Three different measurements of the anteroposterior diameter (APD) of the renal pelvis were done at the renal hilus level, by using a transversal ultrasound scan: the first under spontaneous diuresis conditions, the second after hydration with 1.5 liters of water, and the third with a full bladder 15 min after intravenous injection of 20 mg frusemide. All the patients underwent pyelography. Baseline APD (bAPD) linearly correlated with the PAD both after hydration and frusemide (r = 0.89 and r = 0.84, respectively). A descriptive evaluation of the frequency distribution of the bAPD suggested the possibility that the data samples could belong to three populations with different underlying pathophysiological conditions. Correspondence analysis between bAPD distribution and PUO suggested that the best grouping of data was: group 1(11 patients) bAPD < 13 mm, group 2(14 patients) 13 ≥ bAPD < 20 mm, group 3(17 patients) bAPD > 20 mm (likelihood ratio mχ² 46.36; d.f. = 2). Standard intravenous pyelography showed an increase in pelvis size compatible with PUO in 2 patients from group 2 and in all patients from group 3. At the end of the test, in group 3 APD increased by 20.9 ± 5.6 mm while in group 2 and group 1 the increase, though significant, was moderate (respectively, 7.3 ± 4.6 and 7.3 ± 4.9 mm) and the APD never exceeded 30 mm. In conclusion, the stimulated diuresis test is an important tool for sonographic diagnosis of pelvic dilations. It may be regarded as a valid alternative for pyelography and other urodynamic tests, particularly for children and for patients with a suspected obstruction of the upper urinary tract.

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Section: Discussionmentioning

confidence: 99%

Ultrasound Diagnosis of Suspected Urinary Tract Obstruction Using a Stimulated Diuresis Test

Meola

Giuliano

Morelli

et al. 1995

Nephron

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“…Radioisotope (RI) counts versus time curves for each kidney, corrected by subtracting background activity, were calculated after setting regions of interest (ROIs) on the display. Renal function was assayed in every renal unit using O'Reilly patterns [9]: type 1 was normal; type 2 was renal failure; type 3a was non-obstructed dilated, and type 3b was obstructed pattern.…”

Section: Methodsmentioning

confidence: 99%

Renography as a Measure of Renal and Neobladder Function in Patients with Ileal Bladder Substitution

Nishiyama¹,

Terunuma²,

Takeda

et al. 2002

Urol Int

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Introduction: Using renography, we evaluated the function of both the kidneys and neobladder of 20 patients who underwent ileal bladder substitution. Methods: The patients were measured for renal and neobladder function with renography using ^99mTc MAG3. Renal function was assayed in every renal unit using O’Reilly patterns. Voiding function was estimated using radioisotope counts for the reservoir. Results: Thirty-two of 37 renal units had normal renograms. Five renal units showed non-obstructive renograms. The percentage of total residual urine (RU) in the reservoir was 30% and more in 6 patients, 10–30% in 8, and <10% in 6. In 7 of 12 patients, the data on estimated RU correlated with the data on measured RU. However, in 5 patients, the data on estimated RU increased more in quantity than the data on RU measured at another time. Conclusions: In patients with bladder substitution the functions of both the kidneys and neobladder could be evaluated in a single renography.

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“…Intravenous pyelography visualizes the ureteral obstruction and the degree of pyelocaryceal enlargement (Fryczkowski, 1972). Renal isotope study is used to determine the renal function and the ureteropelvic urine transportation (O'Reilly et al, 1978;Stage and Lewis, 1981). Moreover, the pressure-flow pelvic perfusion test described by Whitaker et al (1981), ureteral manometry (Kiil, 1978), and electromyogram of the ureter (Tsuchida, 1970 ;Djurhuus, 1981) are reported.…”

Section: Whistle-tippedmentioning

confidence: 99%

The estimation of urine bolus volume for patients with congenital hydronephrosis.

Harada

Noto

Etori

et al. 1985

Jpn. J. Smooth Muscle Res.

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Harada, T., Noto, H., Etori, K., Kumasaki, T., Kigure, T., Nishizawa, 0. and Tsuchida, S. The estimation of urine bolus volume for patients with congenital hydronephrosis.Jap 1) Bolus volume of the hydronephrotic side was 0.05+0.02 (mean+ S.D.) ml at oliguric state, and it was significantly lower than the value of the healthy side which was 0.19+0.07 ml. Injection of diuretics increased the bolus volume of the healthy side ten times or more. On the other hand, the bolus volume of the hydronephrotic side was increased only slightly by the jnjection of furosemide, it being approximately one-fouth of the value of the healthy side.2) The value of bolus frequency was similar to peristaltic frequency which was measured by the electromyogram. The tendency of a decrease was noticed in bolus frequency of the hydronephrotic side but it was not significant.3) Of patients with severe hydronephrosis, the bolus volume of the hydronephrotic side was decreased and the response to the diuretics was not so significant. By bolusmetry, functional or organic obstruction of the ureteropelvic junction was detected.

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Diuresis Renography in Equivocal Urinary Tract Obstruction

Cited by 38 publications

References 3 publications

Ultrasound Diagnosis of Suspected Urinary Tract Obstruction Using a Stimulated Diuresis Test

Ultrasound Diagnosis of Suspected Urinary Tract Obstruction Using a Stimulated Diuresis Test

Renography as a Measure of Renal and Neobladder Function in Patients with Ileal Bladder Substitution

The estimation of urine bolus volume for patients with congenital hydronephrosis.

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