Abstract
Purpose We evaluated whether increased differential renal function on the pentetic acid (DTPA) renogram represents elevated renal function in obstructed kidneys. Materials and Methods In 10 patients with unilateral ureteropelvic junction obstruction and a differential function of 53 percent or greater on the DTPA renogram of the obstructed kidney we performed quantitative single photon emission computerized tomography of dimercapto-succinic acid uptake by the kidneys. Results The absolute uptake of dimercapto-succinic acid was significantly higher in the obstructed kidneys compared to the contralateral normal kidneys (30.0 percent plus/minus 7.9 versus 25.3 percent plus/minus 8.3, t = 3.6, p less than 0.01, respectively). The elevated absolute uptake in the obstructed kidney was due to an increased functional volume compared to the contralateral normal kidneys (126.0 plus/minus 69.7 cc versus 102.3 plus/minus 59.2 cc, t = 4.4, p less than 0.01, respectively). Conclusions The results suggest that increased relative renal function in hydronephrotic kidneys due to ureteropelvic junction obstruction is not an artifact of the DTPA renogram. It may represent a compensatory mechanism that sometimes may overcompensate resulting in a paradoxical hyperfunctioning kidney
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