<sup>99m</sup>Technetium DMSA and the Prediction of Recovery in Obstructive Uropathy

Chibber, Percy Jal; Chisholm, G. D.; Hargreave, T. B.; Merrick, M. V.

doi:10.1111/j.1464-410x.1981.tb03245.x

Cited by 25 publications

(6 citation statements)

References 9 publications

(6 reference statements)

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“…The of renal recovery following obstructive uropathy is contradictory. In a clinical study of patients with a mixture of obstructive pathology, with and without concurrent urinary infection, Chibber et al (1981) found no correlation between DRF estimated before and after relief, often finding that the value of DRF for the obstructed kidney unpredictably underestimated DRF following relief and recovery.…”

Section: Discussionmentioning

confidence: 99%

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Can Renal Blood Flow, Glomerular Filtration Rate or ^99mTc‐DMSA Uptake Predict Outcome in Experimental Unilateral Renal Obstruction?

Kelleher¹,

Anderson²,

Gordon³

et al. 1993

British Journal of Urology

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Single kidney glomerular filtration rate (SK GFR), single kidney blood flow (SK BF) and differential renal function (DRF), using both technetium labelled diethylene-pentaacetic acid (99mTc-DTPA) and dimercaptosuccinic acid (99mTc-DMSA), were examined as predictors of outcome in a pig model of complete unilateral ureteric obstruction. SK GFR and SK BF were unable to predict outcome following relief of obstruction but there was a high curvilinear correlation between DRF assessed at the end of defined periods of obstruction and after relief of obstruction using 99mTc-DMSA. Functional recovery was near complete using DMSA when the loss in DRF did not exceed 30%, after which there was an exponential decline in expected recovery. There was no difference between DRF using 99mTc-DTPA or 99mTc-DMSA in controls or before or after obstruction but significant differences between assessment by these radionuclides existed in the obstructed kidney at 24 h, 5 days, 10 days and 20 days. 99mTc-DMSA is a sensitive agent in the prediction of outcome following acute complete obstruction in the pig but its assessment of DRF in the obstructed kidney differs markedly from that of 99mTc-DTPA.

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Section: Discussionmentioning

confidence: 99%

“…Since the introduction of radionuclides in nephrourology, attempts have been made, with varying degrees of success, to quantify individual kidney function in obstruction in order to predict the outcome following relief of obstruction (Djurhuus et al, 1976;Chibber et al, 1981 ;McDougal and Flanigan, 1981).…”

mentioning

confidence: 99%

Can Renal Blood Flow, Glomerular Filtration Rate or ^99mTc‐DMSA Uptake Predict Outcome in Experimental Unilateral Renal Obstruction?

Kelleher¹,

Anderson²,

Gordon³

et al. 1993

British Journal of Urology

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“…Several agents have been used for this purpose, e.g. 99m Tc‐DTPA) [18,20,22], iodine‐orthoiodohippurate ( 131 I‐OIH) [4,23] and 99m Tc‐DMSA [24,25]. The results of various renal scans are conflicting because the different agents are handled differently by the kidney, and thus measure different aspects of renal function.…”

Section: Methods Of Predicting Recoverabilitymentioning

confidence: 99%

“…to obtain a discrete value of GFR or effective renal plasma flow (ERPF). There is an almost general agreement among urologists that if the relative renographic GFR or ERPF has fallen to <10%, then very little recovery of the kidney function can be expected after de‐obstruction, whereas when >10% kidney function can improve considerably [18,20,22–25]. The better the radionuclide uptake, the better the recuperation after de‐obstruction.…”

Section: Methods Of Predicting Recoverabilitymentioning

confidence: 99%

Recoverability of renal function after relief of chronic partial upper urinary tract obstruction

Shokeir

Provoost²,

Nijman

1999

BJU International

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“…Indeed, most of the studies were on animal models and the human studies were generally retrospective studies (5,7,8). Several renal function variables, such as GFR, serum creatinine level, renal perfusion index, renal parenchyma thickness, resistive index, and scintigraphic methods were evaluated in those studies (5,7,8,9,10).…”

Section: Introductionmentioning

confidence: 99%

To Save or not to Save the Kidney: Relieving Unilateral Obstruction May Significantly Improve an Initially Low Split Renal Creatinine Clearance

Yazıcı¹,

Tavukçu²,

Tınay³

et al. 2016

jus

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What's known on the subject? and What does the study add? ÖZ AmaçÇalışmamızda akut/subakut tek taraflı komplet üreteral tıkanıklığa bağlı böbrek fonksiyonlarının nefrostomi ile tedavi sonrası değişimini göstermek amaçlanmıştır. gereç ve yöntemOtuz hasta prostpektif olarak çalışmaya dahil edilmiştir. Hepsinin üreter taşı olup 24'ünde (%80) üst üreter ve 6'sında (%20) orta üreter yerleşimliydi. Tüm hastaların ileri düzeyde hidronefrozu olduğu için perkütan nefrostomi takılması planlandı. Nefrostomi takıldıktan sonra 1. haftada etkilenen böbrek nefrostomiden ve diğer böbrek üretral kreatinin klirensi ölçümü ile değerlendirilmiştir. Değişikliği saptamak için de 1. ayda nefrostomi ve üretral kreatinin klirensleri hesaplanıp 1. haftadaki sonuçlar ile karşılaştırılmıştır. BulgularHastalarımızın ortalama yaşı 44,6'dır (36-54). Etkilenen böbreğin 1. haftadaki kreatinin klirensi 38,8±4,9 ml/dak iken 1. aydaki değer 42,5±5,4 ml/dk'ya yükselmiştir (p<0,001). Tüm hastaların kreatini klirens analizlerinde %2,3 ile %17,3 arasında artış saptanmıştır. SonuçÇalışma sonuçlarımıza göre tek taraflı komplet üreteral tıkanıklığa bağlı bozulan böbrek fonksiyonu nefrostomi takılması sonrası 1. ayda 1. haftaya göre anlamlı olarak düzelmektedir. Bu düzelme böbrek fonksiyonları sınırda olan tek taraflı tıkanıklığı olan hastalarda asıl tedaviye veya nefrektomi yapmaya karar vermede etkili olacaktır. Anahtar KelimelerKreatinin klirens, nefrostomi, obstrüktif üropati objective The aim of this study was to evaluate the change in acute/subacute unilateral renal function after the relief of complete unilateral ureteral obstruction by nephrostomy. Materials and MethodsThirty patients were prospectively enrolled in the study. All had ureteral stone, which were located in the upper ureter in 24 (80%) and in the middle ureter in 6 (20%) patients. As all patients had high-grade hydronephrosis, a percutaneous nephrostomy catheter was placed for the relief of obstruction. At the first week of urinary diversion, 24-hour creatinine clearance (CC) of both affected and normal kidneys were evaluated. In order to determine the difference, same evaluation was performed on the fourth week of nephrostomy placement. ResultsThe mean age of the patients was 44.6 (36-54) years. The mean CC of the affected kidney was 38.8±4.9 ml/min in the first week of urinary diversion and increased to 42.5±5.4 ml/min at the end of the fourth week (p<0.001). All patients showed an improvement in CC levels ranging between 2.3% and 17.3% with a mean rate of 8.5±4.7%. ConclusionAccording to our results, kidney function may improve during the first month after the relief of obstruction. This improvement may be significant for borderline renal function to determine the curative treatment of an obstructed kidney KeywordsCreatinine clearance, nephrostomy, obstructive uropathy This is first study that evaluated the renal function change after relief of unilateral ureteral obstruction because of ureteral stones.

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^99mTechnetium DMSA and the Prediction of Recovery in Obstructive Uropathy

Cited by 25 publications

References 9 publications

Can Renal Blood Flow, Glomerular Filtration Rate or ^99mTc‐DMSA Uptake Predict Outcome in Experimental Unilateral Renal Obstruction?

Can Renal Blood Flow, Glomerular Filtration Rate or ^99mTc‐DMSA Uptake Predict Outcome in Experimental Unilateral Renal Obstruction?

Recoverability of renal function after relief of chronic partial upper urinary tract obstruction

To Save or not to Save the Kidney: Relieving Unilateral Obstruction May Significantly Improve an Initially Low Split Renal Creatinine Clearance

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99mTechnetium DMSA and the Prediction of Recovery in Obstructive Uropathy

Cited by 25 publications

References 9 publications

Can Renal Blood Flow, Glomerular Filtration Rate or 99mTc‐DMSA Uptake Predict Outcome in Experimental Unilateral Renal Obstruction?

Can Renal Blood Flow, Glomerular Filtration Rate or 99mTc‐DMSA Uptake Predict Outcome in Experimental Unilateral Renal Obstruction?

Recoverability of renal function after relief of chronic partial upper urinary tract obstruction

To Save or not to Save the Kidney: Relieving Unilateral Obstruction May Significantly Improve an Initially Low Split Renal Creatinine Clearance

Contact Info

Product

Resources

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^99mTechnetium DMSA and the Prediction of Recovery in Obstructive Uropathy

Can Renal Blood Flow, Glomerular Filtration Rate or ^99mTc‐DMSA Uptake Predict Outcome in Experimental Unilateral Renal Obstruction?

Can Renal Blood Flow, Glomerular Filtration Rate or ^99mTc‐DMSA Uptake Predict Outcome in Experimental Unilateral Renal Obstruction?