succimer and Ureteral-Calculi

In this case report, we aimed to present our clinical experience in a patient with hydronephrotic and atrophic kidney due to impacted lower ureteral stone.. A 56-year-old male was admitted to our emergency department with flank pain and nausea. A computed tomography scan revealed a 3 cm stone at the distal ureter, causing severe hydroureteronephrosis. Right kidney parenchyma was extremely thin at the medial zone, and some parenchyma was apparent at the upper and lower poles. We planned renal scintigraphy, but it was impossible to perform quickly due to the active appointment list. The patient's kidney was assumed to be atrophic/non-functioning; however, given the long waiting list for renal scintigraphy and the patient's intractable pain, we decided to relieve the patient's pain with urinary drainage. Nephrostomy insertion was denied because of the extra thin parenchyma. About 40 days later, the patient underwent semi-rigid ureterorenoscopy under spinal anesthesia. It was impossible to place a double J stent to the ureter because of the kinked and extremely dilated ureter. So, we decided to place an open-end 6Fr ureter catheter. DMSA renal scintigraphy showed 33% right kidney and 67% left kidney function.. Intractable flank pain might be a predictor of functioning renal parenchyma in hydronephrotic/atrophic kidneys. Renal split function lower than 10% on DMSA scintigraphy might not be an absolute indication of nephrectomy, especially in the obstructed renal unit. Evaluation of renal function after eliminating obstruction might be more reliable.

Topics: Female; Flank Pain; Humans; Kidney Diseases; Male; Middle Aged; Nephrectomy; Nephrons; Succimer; Ureteral Calculi

Urinary LMOX concentration was studied in 18 patients with unilateral ureteral obstruction. The concentration of LMOX in the urine from the mild obstructed kidney was 124 to 2,140 micrograms/ml and 10 micrograms/ml in the severely obstructed ones. The difference was probably due to the intensity and the duration of the obstruction. The patient with 99mTc-DMSA renal uptake of less than 3% also had a urinary LMOX concentration of less than 7 micrograms/ml. The above results seem to show that 7 micrograms/ml in urinary LMOX concentration is a significant figure for treatment of UTI. 99mTc-DMSA renal uptake and renal echogram were used to estimate the excretion rate of antibiotics into the urine.

Topics: Adolescent; Adult; Aged; Humans; Infusions, Intravenous; Kidney; Middle Aged; Moxalactam; Organotechnetium Compounds; Radioisotope Renography; Succimer; Technetium Tc 99m Dimercaptosuccinic Acid; Ureteral Calculi; Ureteral Obstruction

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