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Obstructive uropathy in patients with nonvisualization on renal scan

R A Sherman, M D Blaufox

    Nephron
    |January 1, 1980
    PubMed
    Summary

    Nonvisualization on 131I-orthoiodohippurate (Hippuran) renal scans does not always indicate poor prognosis. Patients with urinary tract obstruction may recover renal function after intervention, even without initial scan visualization.

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    Area of Science:

    • Nephrology
    • Nuclear Medicine
    • Radiology

    Background:

    • Nonvisualization on 131I-orthoiodohippurate (Hippuran) renal scans traditionally suggests a poor prognosis for renal function recovery.
    • This study examines outcomes in patients with nonvisualization to re-evaluate this established belief.

    Purpose of the Study:

    • To determine if nonvisualization on Hippuran renal scans definitively excludes the possibility of recoverable renal function.
    • To emphasize the importance of ruling out urinary tract obstruction in patients with nonvisualizing renal scans.

    Main Methods:

    • Retrospective review of 27 patients with nonvisualization on 131I-orthoiodohippurate renal scans between 1972 and 1977.
    • Categorization of patients based on the cause of renal failure: urinary tract obstruction, chronic intrinsic renal disease, or acute renal failure.

    Main Results:

    • Four out of five patients with renal failure due to urinary tract obstruction recovered renal function after surgical relief.
    • All 16 patients with chronic intrinsic renal disease required chronic dialysis within 3-6 months.
    • None of the 7 patients with acute renal failure (acute tubular necrosis) survived.

    Conclusions:

    • Nonvisualization on Hippuran renal scans in the context of urinary tract obstruction does not preclude the potential for recovering renal function.
    • It remains crucial to exclude urinary tract obstruction as a cause of renal failure, even when renal scans do not show visualization.

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