technetium-tc-99m-gluceptate and Renal-Artery-Obstruction

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.

Topics: Acute Kidney Injury; Adult; Aged; Embolism; Female; Gallium Radioisotopes; Humans; Iodine Radioisotopes; Iodohippuric Acid; Kidney Failure, Chronic; Kidney Neoplasms; Male; Middle Aged; Nephritis, Interstitial; Organotechnetium Compounds; Pentetic Acid; Pyelonephritis; Radionuclide Imaging; Renal Artery Obstruction; Succimer; Sugar Acids; Technetium; Technetium Tc 99m Dimercaptosuccinic Acid; Technetium Tc 99m Pentetate

This report describes an unusual case of extensive vascular thrombosis involving the abdominal aorta and its branches. An 81-year-old man was admitted for anuric acute renal failure and congestive heart failure. An initial renal scan, performed to assess for the possibility of renal arterial embolus, showed scintigraphic evidence of obstruction of the proximal abdominal aorta, as well as markedly decreased perfusion to both kidneys and to the liver and spleen. The patient's condition progressively deteriorated and he expired. An autopsy showed total thrombotic occlusion of a mildly atherosclerotic nonaneurysmal abdominal aorta extending from the level of the superior mesenteric artery distally to the iliac arteries. There was involvement of the renal arteries and the splenic and superior mesenteric arteries by thrombosis. Thus, renal scintigraphy accurately detected the level of obstruction, which was further confirmed by autopsy.

Topics: Acute Disease; Aged; Aged, 80 and over; Aorta, Abdominal; Aortic Diseases; Humans; Male; Organotechnetium Compounds; Radioisotope Renography; Renal Artery Obstruction; Sugar Acids; Technetium Tc 99m Pentetate; Thrombosis

The diagnosis of renal artery embolism should be considered in patients with cardiac disease who present with abdominal or flank pain in association with deteriorating renal function. Often the diagnosis is delayed or missed owing to the nonspecific, varied, and protean clinical manifestations. A case is presented of bilateral renal artery emboli, and initial and long-term scintigraphic and radiographic correlations are provided. Renal scintigraphy should be the initial study of choice. In addition, this procedure allows for sequential noninvasive evaluation of renal function.

Topics: Aged; Atrial Flutter; Electric Countershock; Embolism; Heart Valve Diseases; Humans; Male; Organotechnetium Compounds; Radiography; Radionuclide Imaging; Renal Artery Obstruction; Sugar Acids; Time Factors; Ultrasonography

This study attempted to evaluate the role of glucoheptonate (GHA) in captopril renography in an in vivo laboratory investigation in which postcaptopril glucoheptonate uptake was analysed in awake 2KlC hypertensive rats. Clamped kidney uptake in a previous study was greater in the poststenotic kidney than in the normal kidney (P = 0.01) in rats with mild renal artery stenosis. A glucoheptonate renogram protocol was developed for use in rats anaesthetized with sodium pentobarbital. An 123I-hippuran scan was performed to determine the relative renal function, followed by a control 99Tcm-GHA scan. Five minutes after administering captopril, another 99Tcm-GHA scan was performed. Relative renal uptake was determined between 30 and 90 s postinjection. 99Tcm-GHA uptake in the clamped kidney was more than 50% of total uptake in 3/9 of the abnormal rats' control scans. No abnormal rats clamped kidney 99Tcm-GHA uptake was greater than 50% in the postcaptopril scans. Captopril reduced GHA uptake in all nine of the animals with baseline scans. These findings suggest that the laboratory observation of captopril induced paradoxically increased 99Tcm-GHA uptake in renal artery stenosis may not be observed scintirenographically. Moreover, the data support a potential value of glucoheptonate in captopril renography.

Topics: Animals; Captopril; Hypertension, Renovascular; Iodohippuric Acid; Male; Organotechnetium Compounds; Radioisotope Renography; Rats; Rats, Sprague-Dawley; Renal Artery Obstruction; Sugar Acids

We compared technetium Tc 99m glucoheptonate renal scan with standard renal arteriography in 22 patients with various renal abnormalities. The diagnostic accuracy and degree of image resolution indicates this study is a useful and safe clinical addition to the diagnostic armamentarium.

Topics: Humans; Kidney; Kidney Diseases; Kidney Neoplasms; Organotechnetium Compounds; Radiography; Radionuclide Imaging; Renal Artery; Renal Artery Obstruction; Sugar Acids