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Higuchi T, Hartrampf PE, Buck AK, Pomper MG, Rowe SP, Serfling SE, Werner RA. Role of Functional SPECT and PET in Renal Emergencies. Semin Nucl Med 2023; 53:786-796. [PMID: 37236903 DOI: 10.1053/j.semnuclmed.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 04/14/2023] [Indexed: 05/28/2023]
Abstract
Renal scintigraphy is a centerpiece of nuclear medicine and is also commonly applied for (peri-)acute care. In this regard, referrals by the treating physician include: I.) acute obstructions caused by gradual and infiltrative tumor growth or renal off-target effects under anti-tumor treatment, II.) functional issues in infants, for example, structural abnormalities such as duplex kidneys or uroliths in adults, which can also trigger III.) Infections of renal parenchyma. Renal radionuclide imaging is also requested due to IV.) acute trauma to the abdomen, for example, to assess renal scarring or upon further follow-up after reconstructive surgery. We will discuss clinical applications of (peri-)acute renal scintigraphy, along with future prospects on the use of more advanced nuclear imaging techniques such as renal positron emission tomography.
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Affiliation(s)
- Takahiro Higuchi
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany; Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany; Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
| | - Philipp E Hartrampf
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Andreas K Buck
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Martin G Pomper
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Steven P Rowe
- Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
| | | | - Rudolf A Werner
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany; Comprehensive Heart Failure Center, University Hospital Würzburg, Würzburg, Germany; Division of Nuclear Medicine and Molecular Imaging, The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD
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Telli T, Kaya G, Işik Z, Tuncel M. Colonic Visualization of 99mTc-DMSA Due to Enterovesical Fistula. Clin Nucl Med 2021; 46:66-68. [PMID: 33181753 DOI: 10.1097/rlu.0000000000003386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A 60-year-old woman with recurrent urinary tract infection who had several operations for colorectal carcinoma underwent Tc-DMSA renal scintigraphy which showed an unexpected accumulation of radiotracer in the colon. When symptoms were reviewed, we noticed that she was suffering from pneumaturia and fecaluria which raised the suspicion of enterovesical fistula. Rectal contrast-enhanced computer tomography of pelvis demonstrated enterovesical and enterovaginal fistulas. Colonic radioactivity was considered to be related to retrograde peristalsis of Tc-DMSA from bladder activity via enterovesical fistula. In patients with pelvic surgeries and radiotherapy, radioactivity in the colon should raise the suspicion of enterovesical fistula.
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Affiliation(s)
- Tuğçe Telli
- From the Department of Nuclear Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Lee CH, Park YJ, Ku JY, Ha HK. Clinical application of calculated split renal volume using computed tomography-based renal volumetry after partial nephrectomy: Correlation with technetium-99m dimercaptosuccinic acid renal scan data. Int J Urol 2017; 24:433-439. [DOI: 10.1111/iju.13338] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 02/23/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Chan Ho Lee
- Department of Urology; Pusan National University Hospital; Pusan National University School of Medicine; Busan Korea
- Biomedical Research Institute; Pusan National University Hospital; Busan Korea
| | - Young Joo Park
- Department of Internal Medicine; Pusan National University Hospital; Pusan National University School of Medicine; Busan Korea
| | - Ja Yoon Ku
- Department of Urology; Pusan National University Hospital; Pusan National University School of Medicine; Busan Korea
| | - Hong Koo Ha
- Department of Urology; Pusan National University Hospital; Pusan National University School of Medicine; Busan Korea
- Biomedical Research Institute; Pusan National University Hospital; Busan Korea
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Ahn JS, Kim HJ, Jeon HG, Jeong BC, Seo SI, Lee HM, Choi HY, Jeon SS. Predictive preoperative factors for renal insufficiency in patients followed for more than 5 years after radical nephrectomy. Korean J Urol 2013; 54:303-10. [PMID: 23700495 PMCID: PMC3659223 DOI: 10.4111/kju.2013.54.5.303] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 03/25/2013] [Indexed: 11/18/2022] Open
Abstract
Purpose We assessed the predictive factors for renal insufficiency in patients followed for more than 5 years after radical nephrectomy. Materials and Methods Age, gender, history of diabetes, history of hypertension, body mass index, preoperative estimated glomerular filtration rate (eGFR), serum uric acid, urine albumin, normal renal parenchymal volume, tumor size, and ratio of normal parenchymal volume of the removed kidney to that of the remaining kidney were evaluated retrospectively in 89 patients who underwent radical nephrectomy from January 2001 to December 2005. Patients were included whose renal parenchymal volume was measurable by use of perioperative imaging (computed tomography or magnetic resonance imaging), whose preoperative eGFR was greater than 60 mL/min/1.73 m2, and who were followed for more than 5 years. To measure renal parenchymal volume from imaging, we integrated the extent of the normal renal parenchyma from axial slides of images. Results In univariate and multivariate binary regression analysis, the parenchymal volume of the remnant kidney (p=0.001), a history of diabetes (p=0.035), and preoperative eGFR (p=0.011) were independent factors for renal insufficiency. By use of a receiver operating characteristic curve, a volume of 170 mL was determined to be an appropriate cutoff value, with sensitivity of 58.7% and specificity of 74.4% for the parenchymal volume of the remnant kidney for predicting eGFR less than 60 mL/min/1.73 m2 (area under the curve, 0.678). The parenchymal volume of the remnant kidney was also an independent factor for the downgrading of the chronic kidney disease category in the multivariate linear regression analysis (p=0.021). Conclusions Preoperative eGFR, a history of diabetes, and the radiologic volume of the remaining kidney parenchyma could be useful factors for predicting postoperative renal function. Patients with parenchymal volumes of less than 170 mL have a higher risk of postoperative renal insufficiency, which should be considered carefully when choosing a treatment modality.
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Affiliation(s)
- Joong Seo Ahn
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Gorbatiy V, Iremashvili V, Castro A, Mure A, Ortiz N, Castle SM, Leveillee RJ. Renal volumetric analysis: a new paradigm in renal mass treatment assessment. J Endourol 2012; 27:361-5. [PMID: 22967235 DOI: 10.1089/end.2012.0195] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
UNLABELLED Abstract Background and Purpose: Multiple renal volumetric assessment studies have correlated parenchymal volume with the glomerular filtration rate. The objective of this study was to compare renal volumes before and after treatment of renal masses with either partial nephrectomy or radiofrequency ablation (RFA). PATIENTS AND METHODS We reviewed our prospectively collected database of patients with renal masses who were treated between November 2001 and January 2011 with robot-assisted laparoscopic partial nephrectomy (RALPN), laparoscopic RFA (LRFA), or CT-guided percutaneous RFA (CTRFA). Digital Imaging and Communications in Medicine CT imaging data were analyzed in an open-source viewer. Volumetric calculations were used to measure the normal, enhancing bilateral renal parenchyma and tumor volumes. Normal parenchymal volume loss was compared among treatments. RESULTS There were 96 patients (68 men) with an average age of 68.0 (36-84) years who met our inclusion criteria. The average tumor diameter, tumor volume, and nephrometry score (NS) was 3.5 cm, 32.0 cm(3), and 7.1 in RALPN (n=26), 2.6 cm, 9.8 cm(3), and 7.1 in CTRFA (n=47), and 2.9 cm, 14.3 cm(3), and 7.2 in LRFA (n=23) groups. The percent change in the operated kidney volume was similar in RALPN (-12%±15), CTRFA (-13%±16), and LRFA (-17%±18) groups. NS was the only variable in a multivariate linear regression model that correlated with the amount of volume lost in the ipsilateral kidney. CONCLUSIONS Our retrospective volumetric analysis of renal parenchyma before and after partial nephrectomy or RFA of renal masses revealed that all treatments produce similar volume of collateral damage.
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Affiliation(s)
- Vladislav Gorbatiy
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL 33134, USA.
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Assessing renal function after partial nephrectomy using renal nuclear scintigraphy and estimated glomerular filtration rate. Urology 2012; 80:343-6. [PMID: 22857751 DOI: 10.1016/j.urology.2012.04.054] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 04/04/2012] [Accepted: 04/27/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To create a model intended to more accurately characterize renal function alteration after partial nephrectomy using a combination of renal scintigraphy and estimated glomerular filtration rate (eGFR). METHODS Thirty-two partial nephrectomy patients from a single center with preoperative and postoperative renal scans were reviewed. Renal scan data were used to calculate proportional eGFR in the involved kidney as a product of the percentage function of the operated kidney and total eGFR. Linear regression models were created to describe endpoints (postoperative eGFR, involved kidney percent function, proportional eGFR) as functions of clinical variables associated with kidney damage. RESULTS For the ipsilateral kidney, mean preoperative percent function and eGFR were 50% (SD, 4.8) and 31 mL/min/m(2) (SD, 3.4), respectively; postoperative percent function and involved kidney eGFR were 44% (SD, 9.0) and 27 mL/min/m(2) (SD, 9.0), respectively. Decreased postoperative proportional eGFR was significantly associated with increased clamp time and tumor size in univariate linear regression models. Clamp time was associated with total eGFR, where tumor size was not. Additionally, clamp time and tumor size explain more of the variation in proportional eGFR (R(2) = 0.39 and R(2) = 0.17, respectively), compared to percent effort and total eGFR. CONCLUSION Proportional eGFR has a stronger association with putative factors of renal dysfunction after partial nephrectomy, including clamp time and tumor size, compared to total eGFR, indicating it may be a more sensitive marker of renal function after partial nephrectomy.
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Jeon HG, Gong IH, Hwang JH, Choi DK, Lee SR, Park DS. Prognostic significance of preoperative kidney volume for predicting renal function in renal cell carcinoma patients receiving a radical or partial nephrectomy. BJU Int 2011; 109:1468-73. [DOI: 10.1111/j.1464-410x.2011.10531.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Kanamaru H, Yamamoto M, Nagahama K, Yagihashi Y, Kato K, Oida T, Kannno T, Takao N, Shimizu Y, Shichiri Y. Mercaptoacetyltriglycine-3 renogram is not superior to estimated glomerular filtration rate measurement for the prediction of long-term renal function after nephrectomy. Int J Urol 2011; 18:570-4. [DOI: 10.1111/j.1442-2042.2011.02791.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Funahashi Y, Hattori R, Yamamoto T, Kamihira O, Sassa N, Gotoh M. Relationship between renal parenchymal volume and single kidney glomerular filtration rate before and after unilateral nephrectomy. Urology 2010; 77:1404-8. [PMID: 20570320 DOI: 10.1016/j.urology.2010.03.063] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 03/11/2010] [Accepted: 03/28/2010] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To measure the renal parenchymal volume (RPV) before and after unilateral nephrectomy and investigate the relationship between the RPV and single kidney glomerular filtration rate (GFR). METHODS From November 2003 to August 2009, 183 patients who had undergone unilateral nephrectomy were enrolled in the present study. All patients had undergone preoperative technetium-99m dimercaptosuccinic acid renal scintigraphy. Contrast-enhanced computed tomography was performed before and 6 months after surgery. RPV was calculated as the normally functioning tissue, excluding tumors or nonenhanced areas, using a 3-dimensional image reconstruction program. RESULTS The mean split GFR of the remaining kidney increased by 21.2%, from 41.6 to 49.5 mL/min/1.73 m(2) at 6 months after nephrectomy. The mean RPV of the remaining kidney increased by 9.3%, from 164.2 to 178.8 cm(3) after nephrectomy. The preoperative relative RPV of the remaining kidney was 58.8% (range 37.2%-97.9%) and the technetium-99m dimercaptosuccinic acid uptake was 62.2% (range 39.6%-100%), indicating a significant linear correlation (R = 0.865, P <.001). RPV correlated well with the single kidney GFR and patient age, both preoperatively and postoperatively. The postoperative GFR could be predicted by combining the preoperative factors. Multivariate regression analysis revealed that the RPV was positively associated with the single kidney GFR and negatively associated with patient age. CONCLUSIONS The differential renal function correlated well with the RPV and can be estimated by calculating the RPV. Even without using renal scintigraphy, the postoperative GFR can be predicted using our established formula.
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Affiliation(s)
- Yasuhito Funahashi
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Funahashi Y, Hattori R, Yamamoto T, Kamihira O, Moriya Y, Gotoh M. Change in Contralateral Renal Parenchymal Volume 1 Week After Unilateral Nephrectomy. Urology 2009; 74:708-12. [DOI: 10.1016/j.urology.2008.11.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2008] [Revised: 10/26/2008] [Accepted: 11/04/2008] [Indexed: 10/20/2022]
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Hacker HW, Szavay P, Dittmann H, Haber HP, Fuchs J. Pyeloplasty in children: is there a difference in patients with or without crossing lower pole vessel? Pediatr Surg Int 2009; 25:607-11. [PMID: 19504112 DOI: 10.1007/s00383-009-2385-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2009] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Most of the children with hydronephrosis do not require any surgical intervention. However, in individual cases, irreversible loss of renal function can develop. Predictive criteria have been proven ineffective so far in determining in which children obstruction will lead to renal damage. The aim of our retrospective study was to determine the role of a crossing lower pole vessel (CV) in children undergoing pyeloplasty. MATERIALS AND METHODS Between 1996 and 2003, 137 patients (age between 6 weeks and 16 years) with unilateral ureteropelvic junction obstruction and no associated urological pathologies underwent Anderson-Hynes dismembered pyeloplasty. A total of 112 patients were evaluated with complete data. One of the following criteria was considered to be indication for surgery in children with grade 4 hydronephrosis: differential renal function (DRF) <40%; clinical symptoms such as pyolenephritis and flank pain; during follow-up renographies, a reduction of DRF >10% and washout patterns II or III b according to O'Reilly. We looked at the age during surgery and the kind of presentation. DRF was measured using diuretic renography preoperatively and 1 year postoperatively. A postoperative change in DRF of group A (children without CV, n = 84) was compared to that in group B (children with CV, n = 28). RESULTS Median age at the time of surgery was 5 months in group A compared to 23 months in group B. Only in 21.4% of the children with CV compared to 60.7% without CV hydronephrosis was diagnosed by ultrasound examination antenatally. We found a preoperative DRF of 42.4% +/- 11.2 SD in group A, and of 38.9% +/- 11.7 SD in group B. The percentage of postoperative improvement was 3.3% in group A and 15.4% in group B. CONCLUSIONS Children with ureteropelvic junction obstruction and CV received a delayed surgical treatment and showed a greater reduction in differential renal function preoperatively, in contrast to patients without CV. Our data show that CV is a risk factor for deterioration of renal function in children with hydronephrosis and we advocate for an early pyeloplasty in these children, especially if they have a high-grade dilatation and equivocal washout patterns in diuretic renographies. Further prospective studies are necessary in order to understand the natural history of CV and to reveal the importance of the crossing lower pole vessel as a structural anomaly lacking maturation.
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Affiliation(s)
- Hans-Walter Hacker
- Abteilung für Kinderchirurgie, Universitaetsklinik für Kinder- und Jugendmedizin, Tübingen 72076, Germany.
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Lopes de Lima MDC, Ramos CD, Brunetto SQ, Lopes de Lima M, Ferreira U, Sá Camargo Etchebehere EC, Santos ADO, Rodrigues Netto Júnior N, Camargo EE. Estimation of absolute renal uptake with technetium-99m dimercaptosuccinic acid: direct comparison with the radioactivity of nephrectomy specimens. SAO PAULO MED J 2008; 126:150-5. [PMID: 18711653 DOI: 10.1590/s1516-31802008000300003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Accepted: 05/08/2008] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Studies using radionuclides are the most appropriate method for estimating renal function. Dimercaptosuccinic acid chelate labeled with technetium-99m (99mTc-DMSA) is the radiopharmaceutical of choice for high-resolution imaging of the renal cortex and estimation of the functional renal mass. The aim of this study was to evaluate a simplified method for determining the absolute renal uptake (ARU) of 99mTc-DMSA prior to nephrectomy, using the radioactivity counts of nephrectomy specimens as the gold standard. DESIGN AND SETTING Prospective study at the Division of Nuclear Medicine, Department of Radiology, Universidade Estadual de Campinas. METHODS Seventeen patients (12 females; range 22-82 years old; mean age 50.8 years old) underwent nephrectomy for various reasons. Renal scintigraphy was performed three to four hours after intravenous administration of a mean dose of 188.7 MBq (5.1 mCi) of 99mTc-DMSA, which was done six to 24 hours before surgery. The in vivo renal uptake of 99mTc-DMSA was determined using the radioactivity of the syringe before the injection (measured using a dose calibrator) and the images of the syringe and kidneys, obtained from a scintillation camera. After surgery, the reference value for renal uptake of 99mTc-DMSA was determined by measuring the radioactivity of the nephrectomy specimen using the same dose calibrator. RESULTS The ARU measurements were very similar to those obtained using the reference method, as determined by linear regression (r-squared = 0.96). CONCLUSION ARU estimation using the proposed method before nephrectomy seems to be accurate and feasible for routine use.
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Affiliation(s)
- Mariana da Cunha Lopes de Lima
- Division of Nuclear Medicine, Department of Radiology, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil. mailto:
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Weikert S, Christoph F, Müller M, Schostak M, Miller K, Schrader M. Acucise endopyelotomy: A technique with limited efficacy for primary ureteropelvic junction obstruction in adults. Int J Urol 2005; 12:864-8. [PMID: 16323978 DOI: 10.1111/j.1442-2042.2005.01161.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To retrospectively evaluate the ef fi cacy of Acucise endopyelotomy in a series of patients with primary ureteropelvic junction obstruction (UPJO). METHODS Twenty-four patients with a symptomatic primary UPJO underwent Acucise endopyelotomy. Patients with high-grade hydronephrosis and/or poor renal function were excluded. Patients were followed by ultrasound imaging, intravenous urography, diuretic renography, and clinical review. RESULTS The overall success rate was 58% (14/24 patients), with a median follow up of 32 months. Of the ten patients in whom Acucise endopyelotomy failed, seven underwent open pyeloplasty, one required nephrectomy, and two received a permanent ureteral stent. A poor outcome was noted in patients without perioperative extravasation. CONCLUSIONS Our experience with Acucise endopyelotomy indicates that the success rate is lower than initially reported. Larger studies are needed to clarify the role of Acucise endopyelotomy in comparison with other techniques.
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Affiliation(s)
- Steffen Weikert
- Department of Urology, Charité, Campus Benjamin Franklin, Berlin, Germany.
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Shirasaki Y, Saika T, Tsushima T, Nasu Y, Arata R, Kumon H. PREDICTING POSTOPERATIVE RENAL INSUFFICIENCY IN PATIENTS UNDERGOING NEPHRECTOMY FOR RENAL MALIGNANCY: ASSESSMENT BY RENAL SCINTIGRAPHY USING
99m
TECHNETIUM-MERCAPTOACETYLTRIGLYCINE. J Urol 2005; 173:388-90. [PMID: 15643177 DOI: 10.1097/01.ju.0000149980.61593.5f] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE We performed Tc-mercaptoacetyltriglycine (MAG3) renal scintigraphy in patients with renal malignancy to evaluate the function of each renal unit before and after nephrectomy to see if postoperative functional deterioration could be predicted based on scintigraphy results and creatinine clearance. MATERIALS AND METHODS A total of 22 men and 13 women with renal malignancy, including 32 with renal cell carcinoma and 3 with urothelial cancer, were prospectively enrolled in this study. Average patient age was 64.3 years (median 65, range 43 to 88). All patients underwent MAG3 renal scintigraphy before and after unilateral nephrectomy. At the same time serum creatinine and endogenous creatinine clearance were determined. RESULTS Mean serum creatinine was 0.93 mg/dl before and 1.31 after nephrectomy (p <0.0001). Preoperative endogenous creatinine clearance was 70.8 ml per minute per 1.73 m, which decreased to 49.0 ml per minute per 1.73 m after nephrectomy (p <0.0001). Mean MAG3 clearance of the remaining kidney increased 35.1% above baseline from 156.5 to 211.5 ml per minute per 1.73 m following nephrectomy. Spearman rank core analysis revealed that preoperative MAG3 clearance of the remaining kidney significantly correlated with postoperative creatinine clearance (r = 0.596, p = 0.0005). Preoperative MAG3 clearance of the remaining kidney more than 130 ml per minute per 1.73 m coincided with postoperative creatinine clearance above 40 ml per minute per 1.73 m. CONCLUSIONS MAG3 renal scintigraphy may be useful for predicting renal insufficiency after nephrectomy. The findings in this study suggest that preoperative MAG3 clearance of the remaining kidney less than 130 ml per minute per 1.73 m is a risk factor for postoperative renal insufficiency.
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Affiliation(s)
- Yoshinori Shirasaki
- Department of Urology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
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