succimer and Kidney-Calculi

We detected renal parenchymal damage after nephrolithotomy.. We studied 12 patients with renal stones treated with nephrolithotomy. Renal function was determined with serum blood urea nitrogen (BUN) and creatinine values, and 99mtechnetium dimercapto-succinic acid scintigraphy of renal parenchymal tissue was performed before, and 7 days and 3 months after nephrolithotomy. Qualitative and quantitative analyses were done with the Wilcoxon signed rank test.. There was no visual difference in size and appearance of the nephrotomy site between preoperative and postoperative visual scintigraphic evaluations. Quantitative data did not reveal any significant difference between kidneys with and without a nephrotomy incision (p > 0.05), as well as between nephrotomy regions and intact parenchyma within the same kidney (p > 0.05) 3 months after nephrolithotomy. There was no significant difference in serum BUN and creatinine levels between values preoperatively and 3 months postoperatively (p > 0.05).. There was no significant change in renal cortical function and functioning renal parenchymal mass after nephrolithotomy as shown by serum BUN and creatinine levels, and 99mtechnetium dimercapto-succinic acid scintigraphy.

Topics: Adolescent; Adult; Aged; Child; Female; Humans; Kidney; Kidney Calculi; Male; Middle Aged; Nephrostomy, Percutaneous; Organotechnetium Compounds; Prospective Studies; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid

99mTc-DMSA renal scintigraphy was utilized to investigate the influence of ESWL on renal function in comparison with that of PNL. In the beginning, the reproducibility of renal uptake rate by the scintigraphy was examined in eleven healthy volunteers under both non-diuretic and diuretic states. The renal uptake rate was shown to be sufficiently reproducible in the same person in the two different trials. However, the differences and the standard deviations were shown to be a few percentages, which were not statistically significant. Changes in the repeated renal uptake rate seem to indicate not only changes of renal function with the treatment but also some technical errors. Herein, to investigate changes in renal function of the therapeutic side, the uptake ratio rate (rate of uptake rate in the therapeutic side/uptake rate in the contral lateral side) was utilized instead of uptake rate. Renal scintigraphy was carried out in 48 patients with unilateral renal stones before and after ESWL or PNL monotherapy or the combined ESWL and PNL therapies. Within one week of treatment, the uptake ratio rate significantly decreased in patients with PNL or the combined ESWL and PNL, although DMSA uptake rate in the therapeutic side did not significantly changes. Neither renal uptake rate nor uptake ratio rate significantly changed after ESWL treatment. There was no significant difference in changes of uptake ratio rate between Siemens Lithostars Plus and the improved Dornier HM-3 lithotriptors. This study indicated that ESWL monotherapy did not affect the uptake ratio rate, although PNL monotherapy and the combined ESWL and PNL therapies may affect the uptake ratio rate to some extent.

Topics: Adult; Female; Humans; Kidney; Kidney Calculi; Lithotripsy; Male; Nephrostomy, Percutaneous; Organotechnetium Compounds; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid

To evaluate whether reducing tract dilation diameter in PCNL (percutaneous nephrolithotomy) procedures results in minimizing of renal trauma of the percutaneous tract.. A percutaneous renal access tract was established bilaterally to 11 pigs. Two pigs were euthanized immediately after the experiment, while nine pigs were sacrificed 1 month later. The percutaneous accesses were dilated up to 30Fr, 22Fr or 12Fr. The animals underwent a contrast-enhanced computer tomography immediately after the procedure and 30 days later. DMSA-scintigraphy with SPECT-CT was also performed. The kidneys of all animals were harvested for histological evaluation. The volume of scar tissue and the percentage of renal volume replaced by scar tissue were calculated.. Immediate post-procedural CT-scans revealed a significant difference in defect diameter among the three modalities. However, the scar volume calculated on CT-images and histopathology showed a significant difference only when 30Fr dilation was compared to 12Fr dilation. The percentage of scar volume was negligible in all cases, but there was still a statistical difference between 30 and 12Fr dilation. Dilation up to 22Fr revealed no statistical differences compared to the other two modalities. DMSA-scintigraphy showed no scar tissue in any case.. Dilation up to 30Fr may cause a significantly larger scar tissue on renal parenchyma compared to 12Fr dilation as it was shown on CT-images and microscopic evaluation, but based on the DMSA/SPECT-CT this difference seems to be insignificant to the renal function. The scar tissue caused by 22Fr dilation seemed to have no significant difference from the other modalities.

Topics: Animals; Cicatrix; Dilatation; Kidney; Kidney Calculi; Nephrolithotomy, Percutaneous; Nephrostomy, Percutaneous; Succimer; Swine

The aim of this study was to develop a method for estimating DMSA SPECT renal function on each renal pole in order to evaluate the effect of percutaneous nephrolithotripsy by focusing the measurements on the region through which the percutaneous approach is performed.. Twenty patients undergoing percutaneous nephrolithotripsy between November 2010 and June 2012 were included in this study. Both Planar and SPECT-DMSA studies were carried out before and after nephrolithotripsy. The effect of percutaneous nephrolithotripsy was evaluated by estimating the total renal function and the regional renal function of each renal pole. Despite PCNL has been previously reported as a minimally invasive technique, our results showed regional renal function decreases in the treated pole in most patients, affecting the total renal function in a few of them.. A quantification method was used for estimating the SPECT DMSA renal function of the upper, interpolar and lower renal poles. Our results confirmed that total renal function was preserved after nephrolithotripsy. Nevertheless, the proposed method showed that the regional renal function of the treated pole decreased in most patients (15 of 20 patients), allowing us to find differences in patients who had not shown changes in the total renal function obtained from conventional quantification methods.. A method for estimating the SPECT DMSA renal function focused on the treated pole enabled us to show for the first time that nephrolithotripsy can lead to a renal parenchymal damage restricted to the treated pole.

Topics: Female; Humans; Kidney; Kidney Calculi; Kidney Function Tests; Lithotripsy; Male; Middle Aged; Nephrostomy, Percutaneous; Succimer; Tomography, Emission-Computed, Single-Photon; Treatment Outcome

To assess the impact of multiple access tracts during percutaneous nephrolithotomy (PCNL) on short- and midterm renal function, and to determine risk factors predicting renal function deterioration and/or recoverability.. Patients undergoing PCNL with multiple punctures were prospectively enrolled. Preoperative evaluation included dimercaptosuccinic acid and diethylenetriaminepentaacetic acid renography. Patients were classified according to baseline renal function into patients with normal (<1.4 mg/dL) serum creatinine (group A) and patients with elevated (≥1.4 mg/dL) serum creatinine (group B). Patients were followed with serial serum creatinine evaluations and a repeated renography at 12 months. Factors evaluated for possible impact on renal function changes included preoperative renal function, number of access tracts, hypertension, and diabetes mellitus.. There were 102 patients 21 to 65 (mean 39.9) years who completed the study. Fifty patients (group A) had normal preoperative serum creatinine levels and glomerular filtration rate (GFR), which showed no statistically significant change 12 months after PCNL. Fifty-two patients had baseline renal impairment (group B), and they experienced statistically significant worsening of the serum creatinine level and GFR at 12 months postoperatively (P<0.001). Ten (19.23%) patients in group B had a significant deterioration of GFR more than 25%. Independent risk factors for this poor outcome were elevated (≥1.4 mg/dL) preoperative serum creatinine level, diabetes, and hypertension.. PCNL with multiple tracts carries a risk of adversely affecting renal function. Preoperative baseline renal impairment, diabetes, and hypertension are risk factors for significant renal function deterioration after the procedure.

Topics: Adult; Aged; Biomarkers; Creatinine; Diabetes Complications; Female; Glomerular Filtration Rate; Humans; Hypertension; Kidney Calculi; Male; Middle Aged; Nephrostomy, Percutaneous; Radioisotope Renography; Renal Insufficiency; Risk Factors; Succimer

To demonstrate the safety and efficacy of percutaneous nephrolithotomy (PCNL) for management of large renal stones between single-functioning kidney and double-kidney patients.. Thirty single-functioning kidneys and 30 double-kidney patients with a mean age of 38.5 (±15.6) years in the single group and 42.1 (±14.3) years in the double group (range 11-72 years) underwent PCNL for renal stones larger than 2 cm. The effect of PCNL on global and regional cortical activity was measured using quantitative single-photon emission CT measurement of technetium-99m ((99m)Tc) dimercaptosuccinic acid (DMSA) scan uptake by the kidneys before and 6 months after PCNL. Variables assessed were stone bulk, size, location, the number of punctures, and anatomic factors. Average hemoglobin and serum creatinine changes, mean operative time, transfusion rate, hospital stay, and different complications were also assessed.. Mean stone size, mean hospital stay, success rate, and complications were statistically similar in both groups. Mean serum creatinine changes (preoperative and postoperative) were not statistically significant between the two groups (P=0.12). Mean hemoglobin drop (preoperative and postoperative) in both groups was significant, and there was a valuable difference between them (P=0.01). There was a significant difference in the uptake by the treated kidneys before vs after PCNL between both groups statistically (P=0.019), so that the DMSA renal uptake was obviously higher 6 months after PCNL in the double-kidney group compared with its uptake in the single-functioning kidney group.. (99m)Tc-DMSA renal scan confirms that renal function was preserved or even often improved after percutaneous stone removal, and the procedure had no detrimental effects on renal function in both groups. There was no statistically significant difference between these groups in terms of morbidity and stone clearance.

Topics: Adolescent; Adult; Aged; Child; Creatinine; Hemoglobins; Humans; Kidney; Kidney Calculi; Length of Stay; Middle Aged; Nephrostomy, Percutaneous; Postoperative Complications; Succimer; Time Factors; Treatment Outcome; Young Adult

To assess the effect of shockwave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL) on renal morphology and function in children undergoing therapy for upper-tract urolithiasis.. Fourteen patients less than 13 years of age with renal or upper-ureteral calculi who were found suitable for primary SWL or PCNL were evaluated for alteration of renal morphology and function after treatment. Of the 18 renal units treated, SWL and PCNL were performed in 9 units each. The average stone size was 880.2 mm2 (range 110-3800 mm2; median 660 mm2). All children underwent ultrasonic estimation of renal length and parenchymal thickness, 99m technetium dimercaptosuccinic acid (DMSA) and 99m Tc-ethylene dicystine (EDC) scintigraphy, and glomerular filtration rate (GFR) estimation prior to intervention and at 3 and 6 months of follow-up.. Extracorporeal lithotripsy achieved complete clearance in 8 renal units (88%), requiring an average of 6333 shockwaves and an average of 2.2 sessions per renal unit. The efficiency quotient was 42. Percutaneous surgery likewise achieved complete stone clearance in 88% of renal units, with three units requiring more than one tract. Mixed calcium oxalate monohydrate and dihydrate accounted for the majority of the stones. The mean preintervention GFR was 78.3 +/- 14.6 mL/min/1.73 m2 (median 82.5 mL/min/1.73 m2; range 54-98.6 mL/min/1.73 m2), whereas the mean GFR at 3 months was 78.95 +/- 14.4 mL/min/1.73 m2 (median 78.95 mL/min/1.73 m2; range 52-98 mL/min/1.73 m2). A marginal improvement of an average of 0.65 mL/min was noted. Split function EDC scans demonstrated improved drainage in five cases after intervention; the rest were unchanged. Preintervention DMSA scans revealed renal cortical scars in three children. None of the renal units had developed fresh scars at follow-up scans. None of the children developed new-onset hypertension, proteinuria, or alteration in renal size.. In the present study, pediatric SWL and PCNL were not found to cause adverse renal morphologic or functional alteration. Stone clearance resulted in marginally improved function and better drainage.

Topics: Child; Child, Preschool; Cysteine; Female; Glomerular Filtration Rate; Humans; Kidney; Kidney Calculi; Lithotripsy; Male; Nephrostomy, Percutaneous; Organotechnetium Compounds; Prospective Studies; Radionuclide Imaging; Succimer; Treatment Outcome

To determine the efficacy of extracorporeal shock-wave lithotripsy (ESWL) in young children and to evaluate, using renal scintigraphy, any possible adverse effects on renal parenchyma.. From January 1991 to October 1998, 19 infants (aged 5-24 months) underwent ESWL for kidney urolithiasis using a Sonolith 3000 (14 kV, Technomed Corp, Lyon, France) or a Nova (14-20 kV, Direx Medical Systems, Paris, France) lithotripter. The treatment and its effects were evaluated using a physical examination, conventional imaging (plain abdominal X-ray and ultrasonography) and renal scintigraphy 24 h before ESWL and again at least 6 months after the last session of treatment.. Ten children were rendered stone-free by ESWL after one session and 18 after two sessions. At the follow-up (8 months to 8 years, mean 36 months) no hypertension was recorded and no acquired parenchymal damage was detected with conventional imaging. No scars or significant variation of differential function attributable to ESWL were identified on renal scintigraphy.. ESWL is clearly effective for treating infant urolithiasis. There were no renal parenchymal lesions associated with ESWL, even in previously damaged kidneys or after the treatment of staghorn calculi. A long-term follow-up (assessing blood pressure) is mandatory and renal scintigraphy before and 6 months after ESWL in infants is recommended to confirm these results in a larger series.

Topics: Child, Preschool; Female; Follow-Up Studies; Humans; Infant; Kidney; Kidney Calculi; Lithotripsy; Male; Radioisotope Renography; Recurrence; Succimer; Treatment Outcome

A study of 60 patients with stone disease was done, all patients had an IVU and DMSA scan. A DMSA scan helps to show clear cortical images, diagnose cortical scars and absence of cortical tissue. While the IVU allows gross evaluation of kidney function and morphological changes, the DMSA scan is an accurate measure of functioning renal mass. Anyhow, both studies are complementary to each other in patients with stones disease.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Humans; Infant; Kidney Calculi; Male; Middle Aged; Organotechnetium Compounds; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Urography

25 patients with non complicated renal stones were treated by extracorporeal shockwave lithotripsy (ESWL) using Sonolith 3000 an electrohydraulic generator type. They were evaluated before, 15 days and 3 months after ESWL by renal scintigraphy, using for 15 of them technetium -99m dimer captosuccinic acid and technetium -99m-diethylene-triamine acetate for the last 10. This follow up scintigraphic study shows no reduction of glomerular filtration rate after ESWL but some focal parenchymal lesions. Very few of these lesions persist at 3 months. These parenchymal damages seem to be less frequent and less persistent than with piezo-electric lithotripter.

Topics: Adult; Aged; Equipment Design; Female; Glomerular Filtration Rate; Humans; Kidney Calculi; Lithotripsy; Male; Middle Aged; Organotechnetium Compounds; Prospective Studies; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate

Extracorporeal shock-wave lithotripsy has altered the therapeutic approach to urinary stone disease. Recently, a method was developed in which shock-wave generation is obtained piezoelectrically. To evaluate the effect of extracorporeal piezoelectric lithotripsy (EPL) on renal function, 20 patients were studied prior to and after EPL of renal calculi. Renal cortical function was evaluated by using a previously described and validated quantitative single photon emission computerized tomography (SPECT) method to measure individual absolute uptake of technetium-99m dimercaptosuccinic acid (Tc-99m-DMSA). Twenty kidneys were treated, and the 19 contralateral kidneys were without stone disease (1 patient had a single kidney). The absolute kidney uptake of Tc-DMSA in the normal kidneys was 21.4% +/- 6.2% before and 22.2% +/- 6.4% after EPL. For the treated kidneys the absolute update was 16.8% +/- 5.3% and 16.8% +/- 4.7% before and after, respectively. There was no statistical significant difference between pre- and post-treatment values. The absolute kidney uptake was significantly lower (p less than 0.01) in the treated than in the normal kidneys. This study indicates that the EPL procedure did not cause any damage to cortical function detectable by the DMSA uptake.

Topics: Adult; Female; Humans; Kidney; Kidney Calculi; Kidney Cortex; Lithotripsy; Male; Organotechnetium Compounds; Radioisotope Renography; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, Emission-Computed, Single-Photon

From 1984 to 1990, 99mTc-DMSA renal scintigraphy was performed before and after nephrolithotomy (15 cases), pyelolithotomy (15 cases), percutaneous nephrolithotripsy (PNL: 15 cases) and extracorporeal shock wave lithotripsy (ESWL: 16 cases, 17 kidneys) in order to evaluate of influences of renal stone surgeries on split renal function. DMSA renal uptake change ratio of treated kidneys of nephrolithotomy (-24.94 +/- 5.60%) was significantly lower than that of PNL (-0.06 +/- 3.92%), pyelolithotomy (-4.08 +/- 4.79%) (p less than 0.01) and ESWL (-7.72 +/- 3.87%) (p less than 0.05). The average change ratios of contralateral kidneys were as follows: PNL 4.80 +/- 4.21% nephrolithotomy 4.67 +/- 4.73%, pyelolithotomy -1.46 +/- 5.39% and ESWL -2.02 +/- 4.44%. One to 3 weeks after PNL, the cold area on the renal image was found in 10 (66.7%) of 15 cases. In cases of ESWL, DMSA renal uptake decreased even 4-10 weeks (mean 7 weeks) after treatment. In conclusion, possivility of deterioration of renal function after ESWL was suggested.

Topics: Adult; Aged; Female; Humans; Kidney; Kidney Calculi; Lithotripsy; Male; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid

99mTc-DMSA renal scintigraphy was carried out in 54 patients with unilateral renal stones before and after PNL. Four to 8 weeks after PNL the DMSA renal uptake significantly decreased to 17.2 +/- 6.0% from 18.2 +/- 6.7% before PNL. DMSA renal uptake did not change in the contralateral side. Since in some patients changes in the DMSA renal uptake of 5-7% were observed after PNL not only in the PNL side but also in the contralateral side, the renal function was assessed by the formula: DMSA renal uptake in the PNL side/DMSA renal uptake in the contralateral side, and the change of this ratio was evaluated in 44 patients, in whom the renal DMSA uptake in the PNL side was less than two times that in the contralateral side. The DMSA renal uptake ratio decreased to 95.6 +/- 8.7% from the base line 4-8 weeks after PNL. This change was statistically significant. Some functional risks such as massive bleeding with PNL, the fever after PNL and the number of nephrostomy tract did not affect the decrease in the renal function. In 29 patients in whom renal function was reevaluated one year after PNL, the DMSA renal uptake ratio significantly decreased to 94.2 +/- 9.6% from the base line 4-8 weeks after PNL. But the ratio significantly improved to 99.6 +/- 11.6% about one year after PNL. In two patients with a cold area on the renal image, the renal function of the operated side still remained at about 80% levels from the base line even one year after PNL.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Female; Humans; Kidney; Kidney Calculi; Kidney Function Tests; Lithotripsy; Male; Middle Aged; Nephrostomy, Percutaneous; Organotechnetium Compounds; Predictive Value of Tests; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid

Extracorporeal piezoelectric lithotripsy (EPL) has been recently introduced as a non-invasive method for treatment of renal and gall bladder stones. Thirty seven patients treated with EPL for renal calculi were the subjects of radionuclide renal studies. The aim was to evaluate the effects of EPL as a new technology by radionuclide renography. 99Tcm-DTPA and 99Tcm-DMSA studies were performed pre-EPL and one day and one week post-EPL. Various parameters of the sequential radionuclide studies were evaluated. One day post-EPL, changes in parenchymal transit time index, relative uptake function, glomerular filtration rate, time-activity curves and kidney dimensions were observed. At one week post-EPL, different parameters returned to baseline status in the majority of cases. The study indicates that EPL has a variety of effects on the kidney that could be demonstrated and followed by sequential radionuclide renal studies. Furthermore the study suggests spacing of EPL sessions by approximately one week.

Topics: Adult; Female; Humans; Kidney Calculi; Lithotripsy; Male; Middle Aged; Organotechnetium Compounds; Radioisotope Renography; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate

This study reports the results of renal DMSA isotope scan before and after EDAP extracorporeal lithotripsy in 106 patients. An isotope scan was performed before lithotripsy and on the fourth day after lithotripsy and again on the 90th day when alterations were observed on the first post-lithotripsy scan. The assessment of any sequelae was based on the scale of colours of the spectrum, which revealed three types of modifications. The analysis of the results is divided into three periods according to the development in our lithotripsy technique: high firing rates had a success rate of only 40%, with renal scars on isotope scans in 2/3 of cases; low frequency firing rates had a 55% success rate and induced minor changes which were virtually always reversible; in contrast, low frequency firing rates during the 3rd period had a 60% success rate with scars on isotope scans in 1/3 of cases. These isotope scan modifications also depended on the site of the stone. In conclusion, lithotripsy definitely induces renal modifications. The renal parenchyma cannot remain indifferent to lithotripsy beyond a certain threshold. A homogeneous multicentre study with a common protocol is necessary to compare the various lithotriptors and to define cautious and coherent indications for each lithotriptor in the treatment of renal stones.

Topics: Humans; Kidney; Kidney Calculi; Lithotripsy; Middle Aged; Organotechnetium Compounds; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Time Factors

Topics: Adolescent; Adult; Aged; Child; Female; Humans; Kidney; Kidney Calculi; Male; Middle Aged; Nephrostomy, Percutaneous; Organometallic Compounds; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, X-Ray Computed; Ureteral Calculi

Topics: Adult; Female; Humans; Kidney; Kidney Calculi; Lithotripsy; Male; Middle Aged; Nephrostomy, Percutaneous; Organometallic Compounds; Radioisotope Renography; Succimer; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid

99mTc-DMSA and diuretic 99mTc-DTPA renoscintigraphy were performed on 51 kidneys suspected of obstructive nephropathy based on excretory urography to evaluate the residual renal function and the degree of urinary flow impairment respectively. We classified the response to diuretics into 6 patterns: I. normal, IIa. severely damaged renal function, IIb. slow RI excretion without urinary tract visualization (pattern II had no response to furosemide), IIIa. rapid elimination of tracer from the obstructed upper tract, IIIb. slow elimination, and IV. gradual tracer accumulation in the pelvicalyceal system with fairly well preserved renal function but no response. Hydronephrosis varied according to pattern type, in the ascending order of I, IIIa, IIIb and IV (p less than 0.05). Degree of hydronephrosis was inversely related to 99mTc-DMSA uptake, but without statistical significance. 99mTc-DMSA uptake was lower for pattern III as a whole (IIIa + (IIIb) than for pattern I (p less than 0.005), but there was no difference between IIIa and IIIb. Pattern IIa exhibited a significantly lower uptake than any of the other groups. (p less than 0.005) In contrast to previous views, we believe that pattern IIIa indicates a mild obstruction of urinary flow and impaired renal function. Consequently, assessment of obstructive nephropathy should not be based only on urodynamic study but also on differential renal function test.

Topics: Humans; Hydronephrosis; Kidney Calculi; Kidney Diseases; Organometallic Compounds; Pentetic Acid; Radioisotope Renography; Succimer; Sulfhydryl Compounds; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate; Urodynamics

Radionuclide investigations were conducted in 322 patients with nephrolithiasis. Unilateral calculosis was established in 46.3% of the patients, bilateral calculosis in 50.6%. The nature of changes on renograms, scintigrams and in clearance values was shown to depend on the localization of concrements, their size and the presence of concomitant infection. A conclusion has been made as to the usefulness of the methods with relation to operative treatment, especially in a bilateral localization of a pathological renal process.

Topics: Adolescent; Adult; Aged; Citrates; Female; Humans; Iodohippuric Acid; Kidney Calculi; Male; Middle Aged; Organotechnetium Compounds; Radioisotope Renography; Succimer; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid

Two hundred-two 99mTc-DMSA renograms for urologic problems were evaluated. Some technical aspects of the examination and the value of the scintigraphic depth estimation are discussed. Pre- and postoperative uptake values in patients with renal surgery and sequential postoperative examinations are considered. The value of DMSA renograms in predicting recovery in obstructive uropathy and in deciding to opt for conservative therapy or nephrectomy is discussed.

Topics: Aged; Child; Follow-Up Studies; Humans; Kidney; Kidney Calculi; Kidney Diseases; Nephrectomy; Postoperative Period; Preoperative Care; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Ureteral Obstruction

From 1976 through 1984, 94 staghorn calculi of 86 patients were treated in this department. Kidney function was assessed by Tc-DMSA renal scintigraphy consisting of renal cortical imaging and DMSA renal uptake rate, in 84 kidneys preoperatively and 43 kidneys pre- and postoperatively. There was an increase in the postoperative DMSA renal uptake in the operated kidney, in 3 out of 14 kidneys in which pyelolithotomy was performed and in one out of 10 kidneys in which nephrolithotomy was done. It was still impossible to answer the question of which mode of operation should be chosen only from consideration of kidney function study. But it was suggested by the statistical investigation that nephrectomy seemed to be selected in the case of severely decreased renal function. It was reasonable that pyelolithotomy was the best method from the point of predicting the postoperative recovery of renal function. But in the near future, advances in endoscopical stone surgery and extracorporeal procedures, might reduce the damage of the renal function caused by conventional stone surgery.

Topics: Humans; Kidney Calculi; Nephrectomy; Radioisotope Renography; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid

99mTechnetium dimercaptosuccinic acid renal scintigraphy, consisting of the cortical image and dimercaptosuccinic acid renal uptake rate, was used to assess preoperative and postoperative renal function in 55 patients with staghorn calculi. In 14 of 20 patients who had undergone extended pyelolithotomy and in 4 of 22 who had undergone nephrolithotomy there was an increase or no change in the postoperative dimercaptosuccinic acid renal uptake in the surgically treated kidney. However, there was no increase in the postoperative dimercaptosuccinic acid renal uptake in the patients who had undergone pyelolithotomy combined with nephrotomy or partial nephrectomy. Eight per cent of the preoperative dimercaptosuccinic acid renal uptake rate in the diseased kidney seems to be the absolute level for predicting the postoperative recovery of renal function. Dimercaptosuccinic acid renal images provide evidence of morphological changes in the cortex of the kidney with stones and the dimercaptosuccinic acid uptake rate is a useful adjunct for quantitative assessments of preoperative and postoperative residual cortical function.

Topics: Adult; Female; Humans; Kidney; Kidney Calculi; Kidney Cortex; Male; Methods; Middle Aged; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid