Premium
Can Renal Blood Flow, Glomerular Filtration Rate or 99m Tc‐DMSA Uptake Predict Outcome in Experimental Unilateral Renal Obstruction?
Author(s) -
KELLEHER J. P.,
ANDERSON P. J.,
GORDON I.,
RANSLEY P. G.,
SNELL M. E.
Publication year - 1993
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.1993.tb16057.x
Subject(s) - renal function , dimercaptosuccinic acid , kidney , medicine , renal blood flow , urology , pah clearance , extraction ratio , scintigraphy , nuclear medicine , effective renal plasma flow , chemistry , chromatography , extraction (chemistry)
Summary— Single kidney glomerular filtration rate (SKGFR), single kidney blood flow (SKBF) and differential renal function (DRF), using both technetium labelled diethylenepenta‐acetic acid ( 99m Tc‐DTPA) and dimercaptosuccinic acid ( 99m Tc‐DMSA), were examined as predictors of outcome in a pig model of complete unilateral ureteric obstruction. SKGFR and SKBF were unable to predict outcome following relief of obstruction but there was a high curvilinear correlation between DRF assessed at the end of defined periods of obstruction and after relief of obstruction using 99m Tc‐DMSA. Functional recovery was near complete using DMSA when the loss in DRF did not exceed 30%, after which there was an exponential decline in expected recovery. There was no difference between DRF using 99m Tc‐DTPA or 99m Tc‐DMSA in controls or before or after obstruction but significant differences between assessment by these radionuclides existed in the obstructed kidney at 24 h, 5 days, 10 days and 20 days. 99m Tc‐DMSA is a sensitive agent in the prediction of outcome following acute complete obstruction in the pig but its assessment of DRF in the obstructed kidney differs markedly from that of 99m Tc‐DTPA.