Obstructive uropathy

Acute radiorenography during attacks of renal colic

Acute radiorenography was compared to emergency excretory urography to evaluate its diagnostic accuracy in 22 patients with clinical signs of renal colic, including erythrocytes in the urinalysis. All 16 patients with delayed excretion and/or dilated renal pelves on excretory urography had delayed excretion of radioactivity on renography. Furthermore, 6 patients with reduced renal function judged by renography had marked or slight delay in excretion on excretory urography. Small stones not causing stasis were found on excretory urography in 2 patients with normal renograms. It is concluded that acute radiorenography is simple, rapid and safe, and identifies accurately patients with abnormal renal function during attacks of colic, with less risks than excretory urography of causing renal damage or aggravating the pain of renal colic.

Nuclear medicine in acute and chronic renal failure

The diagnostic value of renal scintiscans in patients with acute or chronic renal failure has not been emphasized other than for the estimation of renal size. 131I OIH, 67gallium, 99mTcDTPA, glucoheptonate and DMSA all may be valuable in a variety of specific settings. Acute renal failure due to acute tubular necrosis, hepatorenal syndrome, acute interstitial nephritis, cortical necrosis, renal artery embolism, or acute pyelonephritis may be recognized. Data useful in the diagnosis and management of the patient with obstructive or reflux nephropathy may be obtained. Radionuclide studies in patients with chronic renal failure may help make apparent such causes as renal artery stenosis, chronic pyelonephritis or lymphomatous kidney infiltration. Future correlation of scanning results with renal pathology promises to further expand nuclear medicine's utility in the noninvasive diagnosis of renal disease.