succimer and Polycystic-Kidney-Diseases

Angiotensin converting enzyme (ACE) inhibitors has been suggested to halt the progression of chronic renal failure. As the initial step of a controlled trial of this hypothesis, it was investigated whether start of enalapril in patients with severe chronic nephropathy might cause a critical fall in their renal function. Thirty-one patients were studied, 26 on chronic antihypertensive treatment with drugs other than ACE inhibitors and 5 untreated normotensive. 51Cr-EDTA plasma clearance and renal technetium-99m dimercaptosuccinic acid (99mTc-DMSA) scintigraphy were made before and 24 h after start of enalapril, mean dose 9 mg. Blood pressure fell from median 148/88 to 119/78 mmHg (p less than 0.01). Glomerular filtration rate (GFR) fell from median 14 to 12 ml/min/1.73 m2 (p less than 0.01). The median change in GFR was -14% (range -44% to +10%). The split renal function was unchanged and the scintigrams showed no intrarenal activity defects. In conclusion, enalapril caused a fall in GFR, which was clinically acceptable in most of the patients.

Topics: Adult; Aged; Blood Pressure; Clinical Trials as Topic; Diabetic Nephropathies; Enalapril; Female; Glomerulonephritis; Humans; Hypertension, Renal; Kidney Function Tests; Male; Middle Aged; Polycystic Kidney Diseases; Succimer

The renal radiopharmaceutical preparations 99mTc-DMS and 99mTc-GH were examined chemically, biologically and clinically. Both preparations are of high radiochemical purity. The biodistribution of both preparations was examined in experimental animals at different time intervals, from 15 min to 4 hr; the precentage of incorporation of 99mTc-DMS into kindeys is much higher (29.4% to 52.0%) than that of 99mTc-GH (12.80% to 22.20%). Both preparations accumulate to a greater extent in the renal cortex than in the medulla. The most suitable time for renal scintigraphy for 99mTc-DMS is 90--150 min while for 99mTc-GH it is 60--90 min. It is concluded that 99mTc-DMS is more suitable for static scintigrams on the scanner and 99mTc-GH for dynamic studies with the gamma camera.

Topics: Animals; Chronic Disease; Clinical Trials as Topic; Heptoses; Humans; Kidney; Liver; Male; Polycystic Kidney Diseases; Pyelonephritis; Radiochemistry; Radionuclide Imaging; Rats; Succimer; Sugar Acids; Sulfhydryl Compounds; Technetium; Time Factors; Tissue Distribution

To determine the frequency of fetal urinary tract anomalies and to characterize the types of such abnormalities detected on ultrasonography and the outcome of affected patients during a 15-year period at our institution.. We retrospectively reviewed the findings on maternal prenatal ultrasound examinations and the postnatal medical records of 56 children with urinary tract abnormalities detected by prenatal ultrasound examination at Mayo Clinic Rochester from November 1979 to June 1994.. Of the 56 children, 18 (32%) had severe urinary tract anomalies in conjunction with oligohydramnios, pulmonary hypoplasia, and perinatal death (Potter's syndrome). The other 38 infants had various urinary tract abnormalities--most commonly, isolated hydronephrosis and multicystic dysplasia of the kidney. Six of the 38 children had more than one renal abnormality detected prenatally. Reflux was noted in association with prenatally detected urinary tract abnormalities in 4 of 32 newborns (12%) who underwent voiding cystourethrography. In fetuses with normal amniotic fluid volume, the perinatal outcome was good. Children with lower urinary tract obstruction had evidence of more severe renal dysfunction than did those with involvement at more proximal levels. The presence or absence of urinary tract obstruction postnatally could not be determined reliably on the basis of prenatal ultrasound appearance.. In this study, more than half of all prenatally detected urinary tract abnormalities were isolated hydronephrosis or multicystic dysplasia of the kidney. Postnatal renal function could not be reliably predicted on the basis of prenatal ultrasound findings.

Topics: Female; Follow-Up Studies; Humans; Hydronephrosis; Infant; Infant, Newborn; Kidney Function Tests; Lung; Male; Oligohydramnios; Organotechnetium Compounds; Polycystic Kidney Diseases; Pregnancy; Pregnancy Outcome; Radionuclide Imaging; Retrospective Studies; Severity of Illness Index; Succimer; Syndrome; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Mertiatide; Technetium Tc 99m Pentetate; Ultrasonography, Prenatal; Ureterocele; Urinary Bladder Neck Obstruction; Urinary Tract

Topics: Child; Humans; Organotechnetium Compounds; Polycystic Kidney Diseases; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Mertiatide

Topics: Diagnosis, Differential; Epilepsies, Myoclonic; Female; Humans; Infant; Infant, Newborn; Polycystic Kidney Diseases; Succimer; Tuberous Sclerosis; Ultrasonography; Urography

During a 6-year period (1979-1985), 142 neonates with significant hydronephrosis were seen. Seventy-eight percent of the cases were discovered on fetal screening during obstetric sonography. Maternal/fetal intervention was virtually never indicated and most babies were asymptomatic. The most common conditions found were obstruction of the ureteropelvic junction (41%), obstruction of the distal ureter (usually primary megaureter) (23%), upper-pole hydronephrosis associated with duplex anomalies (13%), and posterior urethral valves (10%). Seventeen neonates with multicystic dysplastic kidney were seen (three per year or one for every eight with hydronephrosis). In comparison, during the 30-year period, 1947-1977, 146 neonates with significant hydronephrosis were seen. Most cases were discovered because the patients had signs and/or symptoms--either an abdominal mass (an enlarged kidney or bladder) or urosepsis. The three most common conditions were obstruction of the ureteropelvic junction (22%), posterior urethral valves (19%), and ectopic ureterocele (14%). During this period, 53 neonates with multicystic dysplastic kidney were discovered (two per year or one for every three with hydronephrosis). The dramatic increase in the number of neonates found to have hydronephrosis is primarily due to the widespread use of obstetric sonography and concomitant fetal screening. The pattern of causes before 1979 represented the incidence of symptomatic lesions. The current pattern more accurately reflects the true incidence of congenital anomalies of the urinary tract.

Topics: Humans; Hydronephrosis; Infant, Newborn; Kidney; Organometallic Compounds; Pentetic Acid; Polycystic Kidney Diseases; Radiography; Radionuclide Imaging; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate; Ultrasonography; Urethra; Urinary Bladder; Vesico-Ureteral Reflux

Indium-111-labeled leukocyte scanning is a highly sensitive and specific method of detecting abscesses. This report describes a patient with polycystic kidneys and a single infected cyst. Ultrasound could not determine which cyst was infected, but the infected cyst could be localized by [111In]leukocyte imaging in conjunction with a [99mTc]DMSA renal scan. The two radionuclide studies were used to identify an infected renal cyst and direct ultrasound guided aspiration.

Topics: Adult; Escherichia coli Infections; Humans; Indium; Leukocytes; Male; Polycystic Kidney Diseases; Radioisotopes; Radionuclide Imaging; Succimer; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Ultrasonography

Topics: Child; Child, Preschool; Female; Humans; Kidney; Male; Polycystic Kidney Diseases; Pregnancy; Pyelonephritis; Radionuclide Imaging; Succimer; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Kidney; Liver Diseases; Male; Middle Aged; Polycystic Kidney Diseases; Radionuclide Imaging; Succimer; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Tomography, X-Ray Computed; Ultrasonography; Urography

Topics: Adult; Aged; Female; Humans; Kidney; Kidney Function Tests; Male; Middle Aged; Polycystic Kidney Diseases; Prognosis; Radionuclide Imaging; Succimer; Sulfhydryl Compounds; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid

Renal scintigraphy with 99Tc-dimercaptosuccinic acid (DMSA) was used to determine the prognosis of patients with adult polycystic kidney disease. In 40 patients, DMSA renal uptake rate, serum creatinine and blood urea nitrogen (BUN) were examined in different periods, at least twice a year. These parameters were plotted on semilogarithmic paper against the course of observation period (years or months in duration). As the impairment of renal function progresses, these parameters gradually worsen, DMSA renal uptake decreases and serum creatinine and BUN elevate linearly. In the terminal stage when hemodialysis is required, total DMSA uptake decreased to less than 1%, and this paralleled the levels of 100 mg/dl of BUN and 10 mg/dl of serum creatinine. Accordingly, when linear lines of parameters are extended to those levels obtained in hemodialysis patients, the years and months which coincide on the abscissa can be accounted for when initiation of the hemodialysis is taken into consideration. Analysis of this linear relation in individual patients allows for an estimate of the progression of this disease and may assist in the determination of the effects of conservative treatment. This method also indicates that the level of DMSA uptake at the initial diagnosis is a critical factor in assessing the prognosis of the patient.

Topics: Adult; Aged; Female; Humans; Kidney; Male; Middle Aged; Polycystic Kidney Diseases; Prognosis; Radionuclide Imaging; Renal Dialysis; Succimer; Sulfhydryl Compounds; Technetium