RADIOISOTOPE SPLIT RENAL FUNCTION AND DIURETIC RENOGRAM IN THE SURGICAL MANAGEMENT OF PELVO-URETERAL JUNCTION

Abstract

For assessing the drainage of pelvo-ureteral junction (PUJ) and the affected kidney function, diuretic renogram (DR) utilizing furosemide and the determination of relative split renal function (RSRF) were performed with ^99mTc-DTPA.
I. In non-diuretic dynamic renal scan, 1 to 2 minute kidney uptake (less background) was counted in 10 studies.
The percentage of each total kidney count and that of each matrix kidney count were expressed for total split renal function (t-SRF) and matrix split renal function (m-SRF). In the relationship to biochemically measured creatinine clearance, the regression line of t-SRF had a correlation coefficient of 0.9663 and that of m-SRF had a less correlation coefficient (γ=0.8396).
II. DR were performed in 30 patients with PUJ stenosis.
In comparison of preoperative excretory urography (IVP), the kidneys of obstructive pattern in DR disclosed more marked dilation of pelvo-caliceal system and a thinning of renal cortex. Postoperatively, eleven of 14 kidneys (78.16%) were assessed to have effective patency in DR, but there was no correlation to the figures of pelvo-caliceal system and cortical thickness.
Although the mean half time of diuretic excretion (D-T 1/2) in the renal pelvis was not comparable with the absolute pressure of pressure flow study, DR were closely correlated with clinical course.
DR study including RSRF has ample clinical usage in deciding the operative application of PUJ stenosis and its postoperative follows.