[Radionuclide functional tests in transplanted kidneys].

Area of Science:

• Nuclear Medicine
• Nephrology
• Transplant Surgery

Background:

• Kidney transplantation is a critical treatment for end-stage renal disease.
• Monitoring transplanted kidney function is essential for patient outcomes.
• Assessing renal function requires evaluating both glomerular and tubular components.

Purpose of the Study:

• To evaluate the clinical utility of combined first-pass and dynamic functional renal studies in kidney transplant recipients.
• To compare the diagnostic value of different nephroaffine radionuclides (99mTc-DTPA, 99mTc-MAG3, 99mTc-PAHIDA) in assessing renal transplant dysfunction.
• To investigate the differential diagnostic potential of radionuclide behavior in post-ischaemic acute tubular lesions.

Main Methods:

• Clinical evaluation of 140 combined first-pass and dynamic functional renal studies in 50 kidney transplant patients.
• Analysis of renal handling of 99mTc-DTPA (glomerular), 99mTc-MAG3 (tubular), and 99mTc-PAHIDA (glomerulo-tubular).
• Assessment across various types of renal transplant dysfunction.

Main Results:

• 99mTc-MAG3 provided the most clinically useful information across all levels of renal function.
• Discordant behavior of glomerular and tubular agents in post-ischaemic acute tubular lesions was observed.
• This discordance suggests potential for valuable differential diagnosis.

Conclusions:

• Combined first-pass and dynamic functional renal studies are helpful for monitoring kidney transplant patients.
• Successive application of glomerular and tubular agents is essential for differential diagnosis of acute tubular lesions.
• Interpretation of study results must consider clinical context and other relevant findings.