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PubMed1976

[Kidney function test after partial nephrectomy (author's transl)].

A new method for testing the function of the kidney after partial nephrectomy is reported. By means of radioisotope renography, urography and radioisotope clearance ('single-shot' method) it is possible to prove the function of the single kidney. The clearance in regard to the size of the shadow of the kidney assessed by urography allows to estimate the specified kidney function. We used these methods in ten patients and we detected that the loss of function is more extensive than expected by the operative reduction of the kidney parenchyma only. The causes for this are discussed.

Humans↗
PubMed2001

Determination of glomerular filtration rate per unit renal volume using computerized tomography: correlation with conventional measures of total and divided renal function.

PURPOSE: Previous studies suggest that functional computerized tomography (CT) can measure glomerular filtration rate (GFR) per unit renal volume. We compared this index with conventionally determined GFR measurements. MATERIALS AND METHODS: A total of 16 men and 8 women 63.3 +/- 14.9 years old (range 31 to 88) were studied using with contrast enhanced CT. A single slice of kidney was scanned sequentially after bolus injection (0.5 to 1.0 ml. per second(-1)) of 20 ml. iopamidol (300 mg. iodine per ml.(-1)). GFR per volume of kidney was calculated using a Patlak graphical analysis, and this index was multiplied by renal volume on CT to yield global GFR (ml. per minute(-1)). Divided function was also calculated. GFR and divided renal function were calculated in all cases from radioisotope renography with 99m diethylenetetraminepentaacetic acid. In 12 subjects in whom 24-hour urine collection was possible GFR was also calculated from creatinine clearance. RESULTS: A strong correlation was observed between divided renal function, expressed with respect to the right kidney calculated from CT (52.7 +/- 14.8%, range 19.9% to 97.4%) and by radioisotope renography (51.7 +/- 14.6%, range 18.9% to 92.6%, r = 0.97, p <0.0001). A strong correlation (r = 0.92, p <0.0001) was also seen between global GFR determined by CT (80.1 +/- 43.9 ml. per minute(-1), range 38.2 to 197.9) and creatinine clearance (72.4 +/- 47.5, range 14.6 to 168.5), and was stronger than the correlation between the radioisotope and creatinine clearance method (r = 0.67, p = 0.02) in the same patients. CONCLUSION: Functional CT using nonionic contrast material can measure GFR normalized to renal volume and is an accurate alternative to conventional methods of renal function evaluation.

Adult↗
PubMed2005

Treatment of emphysematous pyelonephritis with broad-spectrum antibacterials and percutaneous renal drainage: an analysis of 10 patients.

BACKGROUND: This retrospective study was designed to determine the efficacy of broad-spectrum antibacterials combined with percutaneous renal drainage in the treatment of emphysematous pyelonephritis (EPN). METHODS: From July 1992 to September 2002, 10 patients (nine females and one male) with EPN were managed at our institution. All patients had diabetes and presented with fever and chills, flank pain or tenderness, vomiting, and altered consciousness. The diagnosis of EPN was confirmed by the presence of intraparenchymal and/or perinephric gas in imaging studies (kidney-ureter-bladder film, sonogram, and/or computed tomography scan). Broad-spectrum antibacterial therapy, combined with percutaneous renal drainage, was started in all patients. Follow-up studies consisted of computed tomography scan and technetium-labeled diethylenetriaminepentaacetic acid (DTPA) radioisotope renography. RESULTS: The outcome was good in all patients. Three patients underwent delayed nephrectomy due to non-functioning of the involved kidney. The DTPA radioisotope renography results (glomerular filtration rate of the diseased kidney/ contralateral healthy kidney) were 0/57 mL/min, 2.7/68.1 mL/min and 3.7/63.9 mL/min. CONCLUSION: Combined broad-spectrum antibacterial therapy and percutaneous renal drainage is a safe and effective treatment for EPN, especially in high-risk patients for whom nephrectomy under general anesthesia is not feasible.

Aged↗