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[Diagnostic value of the 131 I-hippuran clearance in chronic pyelonephritis]
Insights
131I-hippuran clearance effectively detects early kidney dysfunction in chronic pyelonephritis patients. This method identifies renal function changes sooner than other tests, aiding timely diagnosis and management.
Area of Science:
- Nephrology
- Nuclear Medicine
- Diagnostic Imaging
Context:
- Chronic pyelonephritis can lead to progressive kidney damage.
- Accurate assessment of renal function is crucial for managing this condition.
- Existing diagnostic methods may not detect early functional decline.
Purpose:
- To establish the lower normal limit of 131I-hippuran clearance for effective plasma flow determination.
- To evaluate the utility of 131I-hippuran clearance in diagnosing early renal function disturbances in chronic pyelonephritis patients.
- To compare the sensitivity of 131I-hippuran clearance with other renal function tests.
Summary:
- A 9-year study involving 867 chronic pyelonephritis patients established a lower normal limit of 487 ml/min for 131I-hippuran clearance.
- 131I-hippuran clearance identified early renal function disturbances in 28.9% of patients with normal urine concentrating ability and 45% with maintained concentrating power.
- The study suggests that 131I-hippuran clearance is a more sensitive indicator of early renal functional impairment than tests like urine concentrating ability (ING) or Volhard's test.
Impact:
- Recommends broader use of 131I-hippuran clearance in managing chronic pyelonephritis.
- Enables earlier detection of kidney dysfunction, potentially improving patient outcomes.
- Highlights the value of nuclear medicine techniques in nephrological diagnostics.
Abstract:
The authors report on their 9-year experience concerning the results of the determination of the effective plasma flow by means of the 131J-hippuran clearance in patients with chronic pyelonephritis. On account of the disagreements in literature it was our first task to establish the lower normal limit. Issuing form the parallel investigations with the classical PAH-clearance in 50 patients and in a control group of 71 patients with hearlhy kidneys 487 ml/min were taken into consideration as lower normal limit. The authors examine in 867 patients with chronic pyelonephritis whether it is possible to diagnose relatively early disturbances of the renal function in values of the hippuran clearance lower than 487. It was established that in 28.9% of these patients the ING was normal, in 45% the concentration power maintained and in 70% the rest nitrogen in the serum was not increased. These results allow the recommendation of a broader application of the hippuran clearance in patients with pyelonephritis, since by means of this method relatively earlier restrictions of the renal function can be established than by means of other functional tests (ING and Volhard's test).