Disorders In Renal Patients Research Articles

Justification of Performing Magnetic Resonance Imaging of the Kidneys in Patients in Critical Conditions

Acute kidney injury is a serious problem in intensive care and healthcare in general. The aim of the study is to determine the opportunities and justify the expediency of performing diffusion–weighted images and ASL-perfusion in assessing morphofunctional renal disorders in patients in critical conditions. Material and methods. 101 patients diagnosed with acute kidney injury on the basis of the RSFHF «City Clinical Hospital № 1» (the town of Smolensk) had magnetic resonance imaging of the kidneys and retroperitoneal organs performed using diffusion-weighted images and ASL-perfusion. The data obtained from the autopsy kidney material of deceased patients (n = 32) were compared with the lifetime indicators of diffusion-weighted images and ASL-perfusion. The control group consisted of 54 volunteers without pathology of the genitourinary system. Results. According to the results of magnetic resonance imaging, all patients were divided into three groups. Group 1 (n = 48) included patients with the following results: there was no qualitative restriction of diffusion, the measured diffusion coefficient was = 1.89–2.1´10– 3 mm2/s, ASL-perfusion was ≤ 469 ml/100g/min. In the 2nd group (n = 31), the following results were obtained: qualitatively – there was no restriction of diffusion, the measured diffusion coefficient was = 1.89–2.1´10-3 mm2/s, ASL-perfusion was ≥ 470 ml/100g/min. In the 3rd group (n = 22), the presence of diffusion restriction was noted, the measured diffusion coefficient was < 1.79´10-3 mm2/s. ASL-perfusion was not required in this group of patients, the results were false positive. Conclusions. Magnetic resonance imaging of the kidneys using diffusion-weighted images and ASL-perfusion makes it possible to determine morphofunctional renal disorders without the use of invasive techniques, as well as to predict the outcome in each group of patients.

Long term renal outcome after hypertensive disease during pregnancy: a nationwide population-based study.

Hypertensive disease during pregnancy increases the risk of maternal morbidity and mortality and leads to the development of multi-organ dysfunction, including kidney dysfunction. Complicated pregnancies require careful postpartum management to prevent sequelae. It is believed that kidney injury can consistently occur even after delivery; therefore, defining the chronicity and endpoint is essential for establishing diagnostic criteria. However, data on the prevalence of persistent renal complications following hypertensive disease during pregnancy are limited. In this study, we evaluated the risk of developing renal disorders in patients with a history of hypertensive disease during pregnancy. Participants who gave birth between 2009 and 2010 were followed up for 8 years after delivery. The risk of renal disorder development after delivery was compared according to a history of hypertensive disease during pregnancy. Different factors that could affect the course of pregnancy, including age, primiparity, multiple pregnancy, preexisting hypertension, pregestational diabetes, hypertensive disease during pregnancy, gestational diabetes, postpartum hemorrhage, and cesarean section, were adjusted for using the Cox hazard model. Women with hypertension during pregnancy had a higher risk of developing renal disorders after delivery (0.23% vs. 1.38%; P<0.001). This increased risk remained significant even after adjusting for covariates (adjusted hazard ratio, 3.861; 95% confidence interval [CI], 3.400-4.385] and 4.209 [95% CI, 3.643-4.864], respectively). Hypertension during pregnancy can contribute to the development of renal disorders, even after delivery.

Study of purine derivatives and their relation to renal disorders in patients with psoriasis.

Psoriasis (Pso) is a chronic proliferative skin condition associated with hyperuricemia that may impair renal function. The current study investigates the correlation between purine derivatives (PDs) and renal function in patients with Pso. This case-control study comprises 30 psoriatic patients and 30 age- and sex-matched healthy controls. The enzyme-linked immunosorbent assay (ELISA) was used to assess serum xanthine oxidase (XO) and urine albumin levels. Serum uric acid (SUA) and urinary creatinine were measured using the colorimetric method. There was a rise in the related PDs levels in patients with Pso compared to controls, as evidenced by the enhanced SUA levels (p < 0.001) and XO levels (p < 0.001). The presence of the related PDs in the serum was linked to the severity of Pso, and there was also a connection between the related PDs levels in the blood and indicators of renal dysfunction. Moreover, SUA and urinary albumin creatinine ratio (UACR) were found to be significantly correlated (r = 0.371 and p = 0.044), as were XO and UACR (r = 0.422 and p = 0.020). In psoriatic patients with itching and palmoplantar affection, mean SUA levels were considerably more significant than those in other instances (p = 0.005 and p = 0.018, respectively). Pso, being a hyperproliferative disease, is associated with hyperuricemia, which has a harmful effect on kidney function. The related PDs may be unique serological biomarkers for patients with Pso who are at high risk of developing renal abnormalities, especially with higher severity scores.

Risk factors for renal impairment in patients with hematological cancer receiving antineoplastic treatment.

Antineoplastic treatments, mainly chemotherapy, affect the kidneys, causing toxicity, and can trigger acute and chronic kidney injuries. This study aimed to analyze the prevalence of renal disorders in patients with oncohematological neoplasms receiving antineoplastic treatment. This retrospective cohort study included 75 patients with hematological cancer who underwent chemotherapy between 2012 and 2018 in the Hematology Sector of the Walter Cantídeo University Hospital of the Federal University of Ceará. Sociodemographic and clinical data, blood biochemical assessment findings, and glomerular filtration rate (GFR) were analyzed using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The data were tabulated; transferred to the Statistical Package for the Social Sciences software, version 20.0; and analyzed using Pearson's chi-square test or Fisher's exact test for categorical variables followed by a multinomial logistic regression model (p < 0.05). The prevalence of renal disorders was 52.4% according to the CKD-EPI equation for GFR events. There was a significant association between the decrease in GFRs and the following variables: female sex (p = 0.002), diagnosis of multiple myeloma (p = 0.008), start of treatment within 40days (p = 0.005), and the following antineoplastic treatments: cyclophosphamide, vincristine, and prednisone (p = 0.026); irarubicin (p = 0.032); azacytidine, dexamethasone, and cyclophosphamide (p < 0.001); zoledronic acid (p < 0.001); and pamidronate (p = 0.012). CALGB 8811 (p < 0.001) was inversely associated with a reduction in the GFR. The prevalence of renal disorders was high in patients with oncohematological neoplasms receiving antineoplastic treatment. This requires periodic monitoring of the evaluation of renal function since reductions in GFRs were significantly associated with different treatment protocols used.

Evaluation of Kidneys’ Functional State in Acute Lymphoblastic Leukemia Patients Following Hematopoietic Stem Cell Transplantation

BACKGROUND: Hematopoietic Stem Cell Transplantation (HSCT) has recently been a widely used method of therapy in various fields of current medicine, particularly in hematology.Some patients develop renal disorders following HSCT. AIM: This study aims to evaluate the dynamics of changes in the functional state of the kidneys in patients with ALL after HSCT. METHODS: In the period from 2015 to 2021, for the first time in Kazakhstan, patients with acute lymphoblastic leukemia (ALL) who underwent allogeneic and haploidentical HSCT were prospectively examined. RESULTS: We determined that the greatest decrease in glomerular filtration rate occurred in the group of patients who underwent haploidentical bone marrow transplantation. Moreover, we believe that our results are related to known contributing risk factors, such as the type of performed transplantation and the duration of taking medications for the prevention of graft versus host disease. Our results also indicate that the lethal outcome in the group with haploidentical HSCT in the studied patients with ALL was greater than in the group with allogeneic HSCT. CONCLUSION: In conclusion, a decrease in kidney function in patients who have survived HSCT is probably a common complication; however, further prospective studies are required to confirm these results to develop additional algorithms for the treatment and prevention of renal disorders in patients with acute leukemia after HSCT.

Electrolyte and renal disorders in patients with newly diagnosed glioblastoma.

Purpose: Disturbances of electrolytes and renal function have been linked to the prognosis of critically ill patients and recently also of cancer patients. This study aimed to assess electrolyte and renal disorders in glioblastoma patients and evaluate their prognostic effect. Methods: Medical records of patients with newly diagnosed glioblastoma between 2005 and 2018 were retrospectively reviewed for electrolyteand renal function parameters and for demographic, clinical and outcome parameters. Results: Electrolyte and renal function disorders were associated with poorer survival in univariate and Kaplan-Meier analysis. Multivariate analysis revealed hypochloremia as an independent prognostic factor for overall and 1-year survival. Conclusion: Only hypochloremia showed an association with glioblastoma prognosis, independentof other known prognostic factors, as age or molecular status.

SUN-007 MONOCLONAL GAMMOPATHY OF RENAL SIGNIFICANCE AND MONOCLONAL IMMUNOGLOBULIN RENAL DAMAGE IN MALIGNANT B-CELL DISORDERS: REAL CLINICAL PRACTICE – WHAT IS BEYOND MONOCLONAL IMMUNOGLOBULIN AMYLOIDOSIS?

Monoclonal gammopathy of renal significance (MGRS) merges paraprotein-mediated renal disorders in patients who do not meet criteria for multiple myeloma (MM) and systemic lymphoma (SL). MGRS is driven by monoclonal immunoglobulin (MIg), secreted by small non-malignant B-cell clone. By definition, diagnosis of MGRS requires identification of MIg deposition on kidney biopsy. Spectrum of MGRS, beyond MIg related amyloidosis, includes various types of tubular and glomerular disorders with organized and non-organized MIg or fragments thereof deposition: light chain proximal tubulopathy (LCPT), crystal-storing histiocytosis, fibrillary glomerulonephritis (GN), type I cryoglobulinemic (Cryo) GN, immunotactiod GN, monoclonal immunoglobulin deposition disease (MIDD), proliferative GN with monoclonal Ig deposits (PGNMID), and C3 GN. Membranous nephropathy (MN) and anti-glomerular basement (anti-GBM) GN have also been described. Same lesions may occur during symptomatic B-cell proliferation, however high tumor mass with massive paraprotein precipitation more often results in cast-nephropathy (CN) in MM, or in glomerular intracapillary deposition of MIgM in Waldenström’s macroglobulinemia (WM). We aimed to evaluate the spectrum of MGRS versus MM/SL associated paraprotein-induced renal damage in patients, treated in our unit in 1997-2017. We identified 168 patients with biopsy-proven paraprotein-induced kidney damage, underwent advanced hematologic evaluation. Patients with MIg amyloidosis were excluded from further analysis. Pathology study included light microscopy and immune staining in all cases, and electron microscopy in 19% of cases. Study group included 41 patients, M/F 20/21, median age 61 [30; 76] years. Indications for kidney biopsy were nephrotic syndrome in 6 (14.6%), decline of kidney function in 17 (41.4%), or both in 18 (43.9%) of cases. Clinical diagnosis and pathology are shown in the Table 1. Tabled 1Clinical setting/Pathology patternMGRS 14 (34.1%)MM 20 (48.7%)WM 6 (14.6%)B-cell lymphoma 1 (2.4%)TotalMIDD10818PGNMID213MN22CN77LCPT33CN+LCPT11CN+MIDD22LCPT+MIDD11Anti-GBM GN11Cryo GN11C3 GN112Intracapillary deposition of MIgM44Total14246145 Open table in a new tab Patients with MGRS presented mainly with MIDD with few cases of PGNMID and MN. Patients with MM demonstrated not only CN, but also LCPT and MIDD, and various combinations of these patterns, single cases of PGNMID and anti-GBM GN were also observed in the setting of MM. Patients with WM presented mainly, but not exclusively, with glomerular intracapillary deposition of MIgM, with single cases of Cryo GN and C3 GN. The only case of B-cell lymphoma showed C3 GN. And vice versa, LCDD and PGNMID patterns were found both in MGRS and MM, and only MN was found exclusively in MGRS setting. CN and LCPT or both and in combination with LCDD were characteristic for MM. C3 GN was found in WM and B-cell lymphoma, single cases of anti-GBM GN and Cryo GN were found in MM and WM respectively. We did not find fibrillary and immunotactoid GN in our case series, most likely because of lack of electron microscopy studies. Conditions like LCPT, LCDD, PGNMID, C3 GN and anti-GBM GN, attributed in the literature mostly to MGRS, are also seen in patients with overt malignant B-cell disorders, demanding advanced henatology evaluation. Dual patterns of renal damage are not that rare, reflecting biclonal nature of B-cell proliferation.

Ear, Nose and Throat Disorders in Renal Patients

Ear, Nose and Throat Disorders in Renal Patients

Correlations between related-purine derivatives and renal disorders in patients with psoriasis vulgaris.

Recent data suggest that severe psoriasis is an independent risk factor for chronic renal disease. In the present study, we investigated the role of related-purine derivatives as predictors of renal dysfunctions in patients with psoriasis. A prospective study was conducted on a group of 45 patients with psoriasis vulgaris and 45 control cases, monitored over a 5-year period. Alterations of renal function, albumin/creatinine ratio (ACR, mg/g) and UA/creatinine ratio (UACR, mg/mg) were determined in spontaneous urine samples. The status of related-purine derivatives was evaluated by quantification of uric acid (UA, mg/dl), adenosine deaminase (ADA, UI/mg protein), xanthine oxidase (XO, UI/mg protein) and 8-hydroxy-deoxy-guanosine levels (8-OHdG, ng/ml) in serum samples. Compared to the controls, in patients with psoriasis there was an increase in related-purine derivatives levels, which was demonstrated by the elevated serum levels of UA (5.1±0.4 vs. 5.4±1.0, P=0.066), ADA (0.14±0.08 vs. 0.29±0.12, P=0.052), XO (0.22±0.11 vs. 0.42±0.21, P=0.011) and 8-OHdG (3.1±0.05 vs. 8.3±4.7, P=0.002). The serum levels of related-purine derivatives were associated with the severity of psoriasis. In addition, there was a link between the serum levels of related-purine derivatives and markers of renal impairment. There were positive correlations between 8-OHdG and ACR (r=0.452, P=0.028) and between ADA, XO, UA, 8-OHdG and UACR (r=0.297 and P=0.032, r=0.301 and P=0.002, r=0.431 and P=0.027, r=0.508 and P=0.002) and negative correlations between UA, 8-OHdG and the estimated glomerular filtration rate (r=-0.301 and P=0.036, r=-0.384 and P=0.002). Thus, severe psoriasis is a risk factor for the development of renal disease.

LC-MS candidate reference methods for the harmonisation of parathyroid hormone (PTH) measurement: a review of recent developments and future considerations.

The analysis of intact parathyroid hormone (PTH) (PTH1-84) is useful in the diagnosis of hyper- and hypocalcaemia, hyperparathyroidism, and in the prevention of bone mineral disorders in renal patients. The analysis is complicated by the presence of PTH fragments, which may accumulate in renal failure and cross-react in immunoassays, including the most recent third-generation immunoassays. Large variability exists between different commercially available assays. This article reviews the current literature on PTH testing, with emphasis on the use of mass spectrometry-based methods, and considers the important sources of variation which still need to be addressed prior to the development of much needed candidate reference methods for PTH analysis. Recently, mass spectrometric methods have been developed for the quantitation of PTH1-84 using surrogate tryptic peptides, but even these methods are subject to significant interferences due to the presence of newly observed modified PTH species, such as oxidised and phosphorylated PTH variants, which can accumulate in patient samples. Further work, including: 1) the use of high-resolution mass spectrometry; and 2) the analysis of PTH without prior protease digestion, is required before these approaches can be considered as reference methods against which other methods should be harmonised.

Clinical Spectrum of Renal Disorders in Patients with Cirrhosis of Liver

Background: There are limited studies describing various renal disorders and their prognostic impact in patients with cirrhosis of liver. The aim of this work was to study the clinical spectrum of renal disorders in patients with cirrhosis of liver and their prognostic impact. Methods: Patients with diagnosis of cirrhosis of liver were included in this study. Cirrhosis was diagnosed using standard clinical criteria. The cirrhotic patients were prospectively analyzed for the presence of renal diseases during the study period from January 2008 to April 2009. Results: Four hundred and four patients were included in this study and renal diseases were present in 44% (n = 178) patients. The spectrum of renal diseases were acute kidney injury (AKI; 24.5%), chronic kidney disease (CKD; 15.6%), acute on chronic renal failure (1.5%), nephritic syndrome (1.5%), and nephrotic syndrome (1%). The types of AKI were acute tubular necrosis (ATN; 44.4%), prerenal failure (36.4%), and hepatorenal syndrome (19.2%). The incidence of renal diseases was 15.7% in class A, 50% in class B, and 54.8% in class C cirrhosis. There was significant increase in mortality in patients with class C cirrhosis versus without renal disease (78.1% vs. 53.2%; p < 0.001). Conclusions: Renal diseases were present in a significant proportion (44%) of cirrhotic patients. ATN was the commonest form of AKI and we noted that the prevalence of CKD was 15.6% in our cirrhotic patients. The incidence of renal disease increased with increase in severity of cirrhosis of liver. The presence of renal disease seems to have adverse prognostic impact on class C cirrhosis.

Prevalence and risk of progression of light-chain monoclonal gammopathy of undetermined significance: a retrospective population-based cohort study

Monoclonal gammopathy of undetermined significance (MGUS) is defined by expression of heavy-chain immunoglobulin (IgH) and is the precursor lesion for 80% of cases of multiple myeloma. The remaining 20% are characterised by absence of IgH expression; we aimed to assess prevalence of a corresponding precursor entity, light-chain MGUS. We used a population-based cohort, previously assembled to estimate MGUS prevalence, of 21,463 residents of Olmsted County, MN, USA, aged 50 years and older. We did a serum free light-chain assay on all samples with sufficient serum remaining, and immunofixation electrophoresis was done for all samples with an abnormal free light-chain ratio or abnormal protein electrophoresis results from the original study. Light-chain MGUS was defined as an abnormal free light-chain ratio with no IgH expression, plus increased concentration of the involved light chain. We calculated age-specific and sex-specific prevalence and rates of progression to lymphoproliferative disorders for light-chain and conventional MGUS and assessed incidence of renal disorders in patients with light-chain MGUS. 610 (3.3%) of 18,357 people tested had an abnormal free light-chain ratio, of whom 213 had IgH expression that was diagnostic of conventional MGUS. 146 of the remaining 397 individuals had an increase of at least one free light chain and met criteria for light-chain MGUS. Prevalence of light-chain MGUS was 0.8% (95% CI 0.7-0.9), contributing to an overall MGUS prevalence of 4.2% (3.9-4.5). Risk of progression to multiple myeloma in patients with light-chain MGUS was 0.3% (0.1-0.8) per 100 person-years. 30 (23%) of 129 patients with light-chain MGUS were diagnosed with renal disease. We define a clinical entity representing the light-chain equivalent of conventional MGUS and posing a risk of progression to light-chain multiple myeloma and related disorders. US National Cancer Institute.

Problems and progresses in speciation of Al in human serum: An overview

Aluminium (Al) is associated with many clinical disorders in renal patients. Al accumulation in brain has also been related to the neurodegenerative processes in Alzheimer's disease. In order to better understand Al transport in the human body, it is necessary to identify and quantify chemical species in which Al is present in body fluids and tissues. Among a variety of biological samples, Al speciation was the most frequently investigated in human serum. Improvements were made in the development of analytical techniques for the determination of the amount and composition of high molecular mass Al (HMM-Al) and low molecular mass Al (LMM-Al) species in human serum. However, due to the complex chemistry of Al in serum, its low total concentration and the high risk of contamination, speciation of Al in biological samples is still a difficult task for analytical chemists. In this work, problems related to speciation of Al in human serum are critically discussed. An overview of the progress that was made by the use of different analytical procedures, in order to propose analytical protocols for reliable speciation of Al in serum at low ng mL(-1) concentration range, is presented.

Clinical and laboratory renal alterations in patients with acquired immunodeficiency syndrome in relation to anatomopathological findings

Clinical as well as renal anatomopathological data of 119 patients with acquired immunodeficiency syndrome from the Hospital of the Faculty of Medicine of Triângulo Mineiro, Uberaba, MG, Brazil, were studied. Mean age was 33 +/- 10.4 years (range 18 to 67 years). White (59%) and male (80%) individuals predominated. Ninety percent of patients came from Uberaba or neighborhood. There were 59 (50%) heterosexual, 25 (21%) homosexual, 17 (14%) bisexual and 18 (15%) unknown. Forty three percent were drug abusers. Fourteen (12.2%) of patients had serum creatinine higher than 3mg/dl, ten days before death, 64% of them showed acute tubular necrosis. Seventy one (61%) patients presented hyponatremia and 8 (7%) had hypernatremia. Hypokalemia was detected in 28 (24%) and hyperkalemia in 8 (7%) patients. Twenty four hours urinary protein was detected in 12 patients, 7 of them presenting more than 1g/24h. Two patients showed segmentar focal glomerulosclerosis, one of them with 24h urinary protein level of 5.5 g and serum creatinine 1.5 mg/dl and no edema. The most (56%) patients had tubulointerstitial nephritis. Clinical, laboratory and types of renal disorders in patients with acquired immunodeficiency syndrome are variable. The glomerular diseases were relatively scarce however, tubulointerstitial lesions are quite frequent, mainly interstitial nephritis and acute tubular necrosis. Not always an anatomoclinical correlation could be observed, because many times the electrolyte disorders were frequently observed only functionally.

Determination of IgA- and IgM-rheumatoid factors in patients with rheumatoid arthritis with and without nephropathy.

To clarify the characteristics and pathogenesis of renal disorders in patients with rheumatoid arthritis (RA). In this study, 143 patients with RA were included, from whom 43 with urinary abnormalities were biopsied. Serum rheumatoid factor (RF) concentrations of IgA and IgM isotypes were also measured in these patients by enzyme linked immunosorbent assay. Light microscopy of renal biopsy specimens showed minor glomerular abnormalities in six patients, mesangial proliferative glomerulonephritis (GN) in 21, membranous nephropathy in seven, renal amyloidosis in seven, and tubulointerstitial nephritis in two. Twelve patients with mesangial proliferative GN and one with minor glomerular abnormalities were found by immunofluorescence microscopy to have abnormalities consistent with IgA GN. Although the concentrations of IgA-RF in patients with IgA GN were slightly raised compared with those with glomerulopathy established by biopsy but not associated with IgA GN, the concentrations of IgA-RF were higher in patients with RA with vasculitis or interstitial pneumonia than those with RA complicated by IgA GN. Mesangial proliferative GN, including IgA GN, may be a frequent renal lesion in Japanese patients with RA. IgA-RF may play little pathogenetic part in the development of IgA GN in RA.

Clinicopathological studies of renal disorders in patients with progressive systemic sclerosis

The renal impairments were studied clinicopathologically in 57 patients with progressive systemic sclerosis (scleroderma). Proteinuria, hematuria, azotemia and hypertension, used as markers for renal involvements, were observed in 3 (5.3%), 4 (7.0%), 2 (3.5%) and 6 patients (10.5%) respectively, at the initial examination. Hypertension was increased 2.6 times at the last observation, although the incidence of other three markers have not changed during the follow-up period. Finally, 17 out of 57 patients (29.8) revealed more than one of these clinical markers throughout the study. The decrease of GFR (CThio) was noticed in 3 out of 36 cases (8.3%), however that of RPF (CPAH) in 11 of 36 patients (30.6%), including 5 without abnormal clinical markers. Histological studies were performed in 12 patients. One showed crescentic glomerulonephritis, two membranous nephropathy, and the remaining 9 minor glomerular abnormalities. On the other hand, the vascular changes such as intimal proliferation of interlobular arteries were frequently observed. The frequency of pulmonary involvements, skin ulcer and gastro-intestinal involvement in the patients with renal lesions were not significantly different from that of the non-renal group. The level of RPF was significantly lower in the patients with skin ulcer than that of those without skin ulcer. No significant difference was noticed in the frequency of renal involvements between the patients with or without anti-Scl-70 antibody.

Clinicopathological study of renal disorders in patients with rheumatoid arthritis

慢性関節リウマチ(RA)の腎障害を臨床病理学的に検討した.組織検索80例中,微小変化10例,メザンギウム増殖性糸球体腎炎21例(局所性変化7例,び漫性変化14例)は,血尿主体の尿異常を呈し,腎機能は良好であった.膜性腎症は8例で, 3例は特殊薬物の使用がなかった.アミロイドーシス合併は14例で,尿異常,腎機能低下が著明であった.膠原病重複は13例で,抗DNA抗体高値や低補体血症を高頻度に認めた.なお,螢光抗体法で,び漫性増殖性糸球体腎炎を中心に14例がIgA腎炎と診断され,また電顕的に糸球体基底膜のび漫性菲薄化を9例に認め,全例金療法歴を有していた. RAには多彩な腎病変が認められ,関節外症状として重要と思われた.

Evaluation of Renal Functional Status Using Probe Renogram Technique and USG

Renal disorder is one of the most common problems in Bangladesh. Probe renogram is a verysensitive, specific, non-invasive and cost-effective procedure for the evaluation of renalfunction. Ultrasonography gives good anatomical information. It is cheap, non-time consumingand non-invasive procedure that requires no extra-preparation for studying kidneys. Combinedrenogram and USG were found to be very useful techniques for the evaluation of kidney'sfunctions. Biochemical parameters do not reflect the appropriate functional status of individualkidneys. Probe-renogram could reveal precisely the renal differential function. Retrospectively129 patients were studied, of which 80 (62.02%) were male and 49 (37.98%) were female, agebetween 8-78 years had come at the NMC, Rajshahi during the period of April 2000 to July 2001for radionuclide renography. The main objective of the study was to evaluate the response ofcombined renogram and USG for preliminary screening of renal disorders in patients beforegoing to other high cost and invasive investigations. Renal obstructions were found in 42 (LK-2Gand RK-16) cases and functional impairment of varying degrees was in 55 patients. Results werecorrelated well with clinical findings and other available diagnostic parameters.doi: 10.3329/taj.v15i2.3907TAJ December 2002; Vol.15(2):56-58