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Related Experiment Videos

Diuresis renography in patients with reduced renal function.

E Hjortsø1, S Fugleberg, L Nielsen

  • 1Department of Clinical Physiology and Nuclear Medicine, Copenhagen County University Hospital, Herlev.

Danish Medical Bulletin
|June 1, 1988
PubMed
Summary

Diuresis renography provides limited information for evaluating the upper urinary tract in patients with impaired kidney function (51Cr-EDTA clearance below 25 ml/min x 1.73 m2). Even higher frusemide doses did not improve diagnostic clarity in these cases.

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Area of Science:

  • Nephrology
  • Nuclear Medicine
  • Urology

Background:

  • Diuresis renography is a common imaging technique for assessing the urinary tract.
  • Uraemic patients often present with reduced kidney function, potentially affecting renography results.

Purpose of the Study:

  • To evaluate the diagnostic utility of diuresis renography in uraemic patients with varying degrees of reduced kidney function.
  • To determine if increasing the frusemide dose improves the information obtained from diuresis renography in these patients.

Main Methods:

  • Diuresis renography was conducted twice on 13 uraemic patients without hydronephrosis.
  • Patients were divided into two groups based on 51Cr-EDTA clearance ( <10 ml/min x 1.73 m2 and 10-25 ml/min x 1.73 m2).
  • Frusemide (0.5 mg/kg or 7.5 mg/kg) was administered intravenously at 20 minutes, and results were compared to eight normal controls.

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Main Results:

  • The response to frusemide in diuresis renography was poor and highly variable in uraemic patients.
  • This lack of clear response was observed even with an increased frusemide dose of 7.5 mg/kg.
  • Results suggest significant limitations in interpreting renography curves for the upper urinary tract in kidneys with 51Cr-EDTA clearance below 25 ml/min x 1.73 m2.

Conclusions:

  • Diuresis renography is not conclusive for assessing the upper urinary tract in uraemic kidneys with significantly reduced function (51Cr-EDTA clearance < 25 ml/min x 1.73 m2).
  • Standard or increased frusemide doses do not overcome these limitations.
  • Alternative diagnostic methods may be necessary for evaluating the upper urinary tract in this patient population.