technetium-tc-99m-pyrophosphate and Kidney-Failure--Chronic

Metastatic calcification, a frequent and potential lethal complication of chronic renal failure, is rarely detected before death because of the absence of specific radiographic abnormalities. We report the case of a patient on haemodialysis, with secondary hyperparathyroidism and a second degree A-V block who had a 99m-Tc-pyrophosphate scan to rule out myocardial infarction. The scintigram showed marked myocardial and lung uptake that is indicative of severe metastatic hydroxyapatite calcifications.

Topics: Adult; Calcinosis; Heart; Heart Block; Humans; Hyperparathyroidism, Secondary; Kidney Failure, Chronic; Lung; Male; Myocardium; Technetium Tc 99m Pyrophosphate; Thallium Radioisotopes; Tomography, Emission-Computed, Single-Photon

Topics: Amyloidosis; Cardiomyopathies; Echocardiography; Electrocardiography; Familial Mediterranean Fever; Female; Heart; Humans; Kidney Diseases; Kidney Failure, Chronic; Male; Nephrotic Syndrome; Proteinuria; Radionuclide Imaging; Technetium Tc 99m Pyrophosphate

10 patients with chronic renal failure (6 women, 4 men), 19 to 59 years of age, duration of the disease form 3 up to 21 years, treated by hemodialysis from 2 to 5 years, were examined. The scintigraphic examination of the bones with 99mTc pyrophosphate (166.5.10(6) MBq) on the third hour after the i.v. application of the radiocolloid, registered by the scanning device SELO-DS-2, allows the discovery of the initial changes of the so called renal osteodystrophy (bone disease in patients on chronic hemodialysis). The coefficient bones/soft tissues may be used as a quantitative index of the renal osteodystrophy in these patients whereas the coefficient calvaria/sternum has not the same diagnostic value.

Topics: Adolescent; Adult; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphates; Female; Humans; Kidney Diseases; Kidney Failure, Chronic; Male; Middle Aged; Radionuclide Imaging; Renal Dialysis; Technetium; Technetium Tc 99m Pyrophosphate

Diagnostic potentialities of investigation of the kidneys using 99mTc-pyrophosphate were studied in 34 patients with rheumatoid arthritis (RA) for articular scintigraphy. The results obtained were compared with those of radionuclide renography with 131I-hippuran and excretory urography. A possibility of investigation of the kidneys with 99mTc-pyrophosphate for the assessment of parenchyma function and kidney urodynamics was shown. Taking into account a high prevalence of nephropathy in RA patients, dynamic renal scintigraphy and clearance registration were recommended at the first stage of articular scintigraphy with 99mTc-pyrophosphate in order to obtain information on the anatomotopographic site and accumulation-evacuatory function of the kidneys.

Topics: Adult; Aged; Arthritis, Rheumatoid; Diphosphates; Female; Humans; Iodohippuric Acid; Joints; Kidney; Kidney Failure, Chronic; Male; Middle Aged; Radioisotope Renography; Technetium; Technetium Tc 99m Pyrophosphate; Time Factors; Tomography, Emission-Computed

Two cases of chronic renal failure showing very interesting technetium-99m-pyrophosphate bone scans are presented. In both cases striking uptake of activity was shown in the left ventricle of the heart, the mucosa of the stomach and in both lungs. This picture was attributed to metastatic calcification in these organs. Cases of metastatic calcification demonstrated with bone-seeking agents have been presented previously, but have mainly shown intense uptake of activity in the lungs and in a few cases, and to a lesser degree, in the stomach. However, we believe that our cases are unique in showing especially the left ventricle of the heart as well as the mucosa of th stomach with exceptional clarity.

Topics: Adult; Bone and Bones; Calcinosis; Diphosphates; Female; Heart; Humans; Kidney Failure, Chronic; Mucous Membrane; Radionuclide Imaging; Stomach; Technetium; Technetium Tc 99m Pyrophosphate

In order to determine the place of Technetium-99m-pyrophosphate bone scintigraphy in the assessment of renal osteodystrophy, 17 patients with chronic renal failure requiring hemodialysis underwent bone scans and these were compared to results of biochemical, radiological and histologic studies. Bone histology was abnormal in all patients with most having evidence of osteomalacia and hyperparathyroid bone disease. Using semi-quantitative scan scores and regional bone-standard ratios, isotope uptake was increased in 16 patients, while 15 had elevated alkaline phosphatase levels and 7 had X-ray changes. An osteoid-osteoclast index combining histological osteomalacia and hyperparathyroid disease was derived and was found to correlate more closely with alkaline phosphatase and parathyroid hormone levels than with scan parameters. It was concluded that bone scans did not provide therapeutically useful information that could not be obtained from biochemical and radiological studies. It appeared that only bone histology could differentiate osteomalacia and hyperparathyroid bone disease.

Topics: Adult; Bone and Bones; Chronic Kidney Disease-Mineral and Bone Disorder; Diphosphates; Female; Humans; Kidney Failure, Chronic; Male; Middle Aged; Radionuclide Imaging; Technetium; Technetium Tc 99m Pyrophosphate