Renogram Research Articles

Regional (compartmental) renogram for hypertension evaluation.

REGIONAL (COMPARTMENTAL) RENOGRAM FOR HYPERTENSION EVALUATIONYEN WANG, M.D., D.SC.(MED.)Audio Available | Share

Renovascular hypertension: Prospective diagnostic yield in a random access population

Over a five-year period, 104 patients with diastolic hypertension were clinically evaluated and studied by arteriography, differential renal function studies, and radioisotopic renography. Based on either a positive differential renal function study and/or response to surgery, the incidence of renovascular hypertension was determined to be 6 per cent. Of the entire group studied, 15 per cent ( 16 104 ) of patients were found to have renal artery stenosis by arteriography. Eight of these patients had normal differential function studies and were excluded from the renovascular group. In the group with a final diagnosis of essential hypertension (87), 22 patients met roentgen criteria for chronic pyelonephritis. All 6 patients with renovascular hypertension had abnormal renograms; 5 of 8 patients with renal artery stenosis and normal differential function studies had abnormal renograms. However, there was an incidence of 15 per cent false positive renograms. Differential renal function studies were carried out on 75 patients, utilizing a modification of the Stamey technique. Of the 6 patients with renovascular hypertension, 2 had negative results on tests by Stamey's criteria; 2 had negative findings on tests by Rapoport's criteria; and there was 1 negative result on a test utilizing PAH (para-aminohippuric acid) excretion ratios as criteria.

Seven cases of hypertension due to segmental renal ischemia.

During the last 10 years, 7 hypertensive patients due to segmental renal ischemia or infarction among total 48 cases of renovascular hypertension have been observed in our clinic.These 7 cases of renal arterial branch stenosis consist of 5 men and 2 women. The youngest case was aged 12 and the oldest 31. Their blood pressures were ranged from 160-225mmHg in systolic and from 84 to 150 in diastolic. Abnormal intravenous pyelogram was found in 4 out of 7 cases. So far as our experience was concerned, clinical features, urinalysis, radioisotope renography, renoscintigraphy and split renal function study were of little value for screening of the patients with renal arterial branch stenosis. However, angiography and provocation test of renin secretion are the best tools for making diagnosis of this type of hypertension. Surgical treatment including nephrectomy and revascularization relieved the hypertension in 5 patients. Antihypertensive drugs were given in one of 5 operated cases and in 2 non-operated cases. Six out of 7 patients remained normotensive.

Present Urologic Status of the World War II Paraplegic : 25-Year Followup. Comparison with Status of the 20-Year Korean War Paraplegic and 5-Year Vietnam Paraplegic

Present Urologic Status of the World War II Paraplegic : 25-Year Followup. Comparison with Status of the 20-Year Korean War Paraplegic and 5-Year Vietnam Paraplegic

Radioisotope Renography in Patients with an Ileal Conduit: The Importance of the Sitting Position

Radioisotope Renography in Patients with an Ileal Conduit: The Importance of the Sitting Position

The Furosemide Wash-out Pyelogram and the Furosemide Radioisotope Renogram in the Diagnosis of Renovascular Hypertension

Le diagnostique d’une hypertension rénale a été établi par la néphrographie isotopique, l’urographie, l’artériographie rénal et l’examen histologique du matériel de biopsie chez un malade de 36 ans. Après une chirurgie de restitution de l’artère rénale gauche la pression sanguine s’est abbaissée à des valeurs normales et l’état clinique du malade s’est amélioré. Avant l’opération, un „wash-out“ par le Furosemide n’a pu être obtenu que sur le côté sain tandis que le côté malade a conservé une opacification élevée du moyen de contraste. Après l’opération, on a pu observer un „wash-out” complet des deux côtés. Une modification distincte de la courbe néphrographique du rein gauche confirmait le succès de l’opération restitutrice. Le pyélogramme „wash-out” par le Furosémide et le rénogramme par le Furosémide sont recommandés comme tests screening additionels pour le diagnostique de l’hypertension rénale.

Radioisotope Renography Improved By Sequential Renal Scintiphotography

Radioisotope Renography Improved By Sequential Renal Scintiphotography

Alterations in Radioactive Isotope Renogram Pattern With Urinary Bladder Filling

Patients without renal disease were examined with scintillation camera renography with the bladder filled and then emptied. Bladder filling produces a renogram pattern of prolonged transit time which is reproducible with or without catheterization. Patients should be asked to void before radioisotope renography, especially when the patient is given a water load and when more than one study is being performed.

Effect of ampicillin on the radioiodohippurate renogram.

Effect of ampicillin on the radioiodohippurate renogram.

A basic study of 131I-hippuran renogram

Radioisotope renography, advocated first by C. C. Winter, has been one of the widely used routine split renal function tests. Yet, no clear analysis has been made on each Segment a, b and c of the renogram curve.With the advent of efficient scinticamera, it became possible to obtain satisfactory scintigrams using the rapidly excreting material, such as Hippuran. And it is now possible that the renal excretion is evaluated not only on linear renograms, but also on dynamic scintigrams (scinticamera). Therefore, renograms have been interpreted in conjunction with the dynamic scintigrams obtained by the scinticamera. With such a current trend in mind, the autoradiography has been performed on the rabbit kidneys and on the mice for our basic understandings of the renograms. Optimal conditions for the satisfactory autoradiography of the rabbit kidneys were determined. The fundamentals were studied.The best method was shown to be the followings; CMC paste was applied on the renal surface, the kidney was immersed for 20 seconds in acetone and dryice for freezing, the specimen was cut into sections in the range of 20-40μ in thickness and finally was exposed to a film by the Contact Method for two to three days (estimated dose: 100μ C).A new method of the whole body autoradiography of the mice, developed by us, was as follows; twos films with different sensitivities (Fuji No. 200 and No. 100) were prepared. The specimen was first placed in contact with the No. 200 film for 2 to 3 days and then with the No. 100 film. By this way, the whole body distribution was shown in detail on the No. 200 film and the intrarenal distribution on the No. 100 film.Analysis of the Segment a of the renogram curve was made by the renogram changing Time Constant and Record Paper Speed and by the autoradiogram, for each tracer, 131I-Hippuran, 131I-PVP and 181I-Human Serum Albumin. It revealed that the Segment a represented not only renal vascularity but also tubular function. But for about ten seconds following the tracer injection, the Segment a signified the pure vascularity.The Segment b was considered to be a period of the tracer (131I-Hippuran) secretion from the proximal tubulus after being retained for a certain time, since the autoradiograms of the rabbits demonstrated that the tracer was found to be distributed in the renal cortex, especiahy in the proximal tubules, in 30 seconds to 60 following the injection and then it shifted to the outer medulla, especially to the distal tubules in. 3 to 4 minutes.Then the tracer moved from the cortex to the medulla in distribution on the autoradiogram of the rabbit kidneys.And on the whole body autoradiogram of mice, a sudden up-rise was observed in the urinary bladder. Therefore, the Segment c, which corresponded with this stage, was thought to mean prompt excretion into the urinary bladder.Besides these findings, the Hippuran distribution in the mice, studied by the whole body autoradiography, have shown a fairly large amount, much more than anticipated, of the tracer existence in the liver in 10 seconds and in the wall of the GI tract in 15 minutes after the injection.

An Assessment of Anderson-Hynes Pyeloplasty by Radioisotope Renography

An Assessment of Anderson-Hynes Pyeloplasty by Radioisotope Renography

Evaluation of renal function, using a scintillation camera and computer.

SIGMAN, BENDER, and Blau (1) have described the use of the autofluoroscope in radioHippuran renography. The uptake and clearance of 1311 Hippuran in various subdivisions of the kidney (cortex, medulla, and pelvis) were plotted. These compartmental renograms aided the investigators in the interpretation of various abnormalitie s seen on the reno gram pattern of the whole kidney. A scintillation camera has been used by Burke and his associates for evaluat ion of ren al function (2- 4). Their method combines good detection efficiency and accurate organ localization with graphic recording of the uptake and clearance of the radioisotope by each kidney. The serial camera images are particularly useful in sorting out the similar renogram patternsof parench ymal disease, renal artery stenosis, and obstruction (2). In the present study we extended scintillation camera and compartmental renography to include computer analysis and print-out of th e data. The valu e of this technic in the assessment of a varie ty of renal diseases is illustrated. Materials and Methods The equipment shown in schemat ic form in Figure 1 consists of a modified scintillation camera with elect ronic splitting of the crystal, analog-to-digital computer, 1,600channel memory system, and high-speed magn etic tape for computer proce ssing. The 1,600 chann els represent a 40 X 40 grid with each channel recording the acti vity from approximately one-half square centimeter of surface area. The data are accumulated in the 1,600 channel memory system and are transferred to magnetic tape at preset time intervals. A FORTRAN program has been written to analyze the tape data on a Control Data Corporation 3300 computer. All patients were given nothing by mouth for twelve hours prior to study. With the patient in a sitting position and use of a kidney, ureter, and bladder study or intravenous urogram as a guide, the camera was directed toward the kidneys from the back. Immediately upon injection of a bolus of 200-500 )lCi of 1311Hippuran intravenously, the scaler, rectilinear chart recorders, and the 1,600-channel memory system with magnetic tape were activated. The data were cleared from the 1,600-word memory onto the tape at O.4-min. intervals. Serial camera images were routinely obtained at approximately one, three, six, twelve, eighteen, twenty-four, and thirty minutes. Additional camera images were taken at later times in selected patients. Following the study, the data were played back from the magnetic tape unit into the 1,600-memory system and displayed on an oscilloscope where the appropriate x-y coordinates of regions of interest (ROI) were selected. The accuracy in the selection of ROI on the oscilloscope was verified at a later time by comparison to the isointensity plot obtained from the computer (Fig. 2). If errors were present in the original ROI selections, appropriate changes were made and the computer reprogrammed.

Interpretation of the Renogram in the follow-up of the Urological Patient

Interpretation of the Renogram in the follow-up of the Urological Patient

Radioisotope renography in the assessment of renal function in the newborn : C. C. Winter, J. Elliott, D. Grace, and A. Robertson. J. Urol. 100:99–103 (August) 1968

Radioisotope renography in the assessment of renal function in the newborn : C. C. Winter, J. Elliott, D. Grace, and A. Robertson. J. Urol. 100:99–103 (August) 1968

Theoretical Considerations Concerning Mathematical Models of Radioisotope Renography

SummaryA mathematical analysis of theoretical models of the radiohippuran renogram is presented. The preliminary considerations are based on a hydrodynamic model and a diffusion model. On the basis of the model assumptions the functions describing radioactivity of the blood, kidneys and urinary bladder are derived. It is demonstrated that by comparing theoretical curves with experimental ones the parameters characterizing some phenomena of hippuran kinetics may be estimated. These parameters are: the clearance of the tracer from the blood, the out-flow of the urine from the kidneys to the urinary bladder, the extravascular diffusion of the tracer and the functional asymmetry of the kidneys.

Radioisotope Renography in the Assessment of Renal Function in the Newborn

Radioisotope Renography in the Assessment of Renal Function in the Newborn

Use of radioisotope renography and intravenous pyelography in carcinoma of the cervix

Radioisotope renography has proved uniquely useful in following patients with cervical cancer because of the ease of performance of the test, lack of need for special preparation, and ability to contribute information in many patients with azotemia. Serial renograms seem to give the most sensitive index to changes in renal function, particularly in patients who are under observation for recurrence of cancer after surgical or radiation therapy. In the patient with iodine hypersensitivity, the renographic technique may be the only procedure which will provide insight into the functional integrity of the urinary tract. However, when direct anatomic information is needed, intravenous or retrograde pyelography must be used.

Experiences with radioisotope renography in children : J. H. Johnston and Irene M. Irving. Arch. Dis. Child. 42:583, 1967

Experiences with radioisotope renography in children : J. H. Johnston and Irene M. Irving. Arch. Dis. Child. 42:583, 1967

Radioisotope renography and scinti-scanning in renal transplantation. Experience with 12 patients.

Radioisotope renography and scinti-scanning in renal transplantation. Experience with 12 patients.

Experiences with radioisotope renography in children.

<h3>Abstract</h3> <h3>Aims</h3> Patients with cardiac disease are considered high risk for poor outcomes following hospitalization with COVID-19. The primary aim of this study was to evaluate heterogeneity in associations between various heart disease subtypes and in-hospital mortality. <h3>Method and results</h3> We used data from the CAPACITY-COVID registry and LEOSS study. Multivariable modified Poisson regression models were fitted to assess the association between different types of pre-existent heart disease and in-hospital mortality. 10,481 patients with COVID-19 were included (22.4% aged 66 – 75 years; 38.7% female) of which 30.5% had a history of cardiac disease. Patients with heart disease were older, predominantly male and more likely to have other comorbid conditions when compared to those without. COVID-19 symptoms at presentation did not differ between these groups. Mortality was higher in patients with cardiac disease (30.3%; n=968 versus 15.7%; n=1143). However, following multivariable adjustment this difference was not significant (adjusted risk ratio (aRR) 1.06 [95% CI 0.98 – 1.15, p-value 0.13]). Associations with in-hospital mortality by heart disease subtypes differed considerably, with the strongest association for NYHA III/IV heart failure (aRR 1.43 [95% CI 1.22 – 1.68, p-value &lt;0.001]) and atrial fibrillation (aRR 1.14 [95% CI 1.04 – 1.24, p-value 0.01]). None of the other heart disease subtypes, including ischemic heart disease, remained significant after multivariable adjustment. <h3>Conclusion</h3> There is considerable heterogeneity in the strength of association between heart disease subtypes and in-hospital mortality. Of all patients with heart disease, those with severe heart failure are at greatest risk of death when hospitalized with COVID-19.