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The Importance of Renal Function in the Interpretation of Diuresis Renography
Author(s) -
BROWN S. C. W.,
UPSDELL S. M.,
O'REILLY P. H.
Publication year - 1992
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1992.tb15480.x
Subject(s) - renal function , diuresis , diuretic , renal blood flow , pah clearance , urology , chemistry , kidney , effective renal plasma flow , medicine , endocrinology
Summary Interpretation of the diuresis renogram is dependent on a full understanding of the factors that contribute to the washout curve, a major determinant being the urinary flow rate induced by the diuretic. Frusemide‐induced flow rates were measured in 86 patients over a 30‐min period and related to creatinine clearance in 39, 99m Tc‐DTPA clearance (glomerular filtration rate (GFR)) in 27, and 123 l‐Hippuran clearance (effective renal plasma flow) in 20. The flow rates 3 to 6 min and 15 to 18 min after administration of the diuretic received specific attention because of their importance to F + 20 and F ‐ 15 diuresis renography respectively. The mean urinary flow rate 15 to 18 min after frusemide was 3.5 ml/min greater than at 3 to 6 min ( P <0.001), explaining the value of the F ‐ 15 renogram in further evaluating equivocal F + 20 curves. Linear relationships were observed between each parameter of function and the 3 to 6 min and 15 to 18 min periods as follows: creatinine clearance r =0.66, r =0.77; 99m Tc‐DTPA clearance r =0.66, r =0.77; 123 l‐Hippuran clearance r =0.59, r =0.71. From regression analysis of the data presented it is possible, with knowledge of total and split function, to predict single‐kidney flow rates. It is demonstrated that these may commonly exceed flow rates used for perfusion studies if function is normal, but a single‐kidney flow rate of 10 ml/min is unlikely to be attained if the single‐kidney GFR is less than 15 ml/min.