Excretory urography and renal scintigraphy for chronic obstructed kidney: Does nonopacity mean nonsalvageability?

Introduction This study aimed to ascertain whether nonopacified kidney on excretory urography (also known as intravenous urography [IVU]) indicates nonsalvageability. Methods We retrospectively reviewed 45 adult patients with chronic unilateral urinary tract obstruction, in whom IVU revealed nonopac...

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Main Authors: Alisa Klaipetch, Sirianong Namwongprom, Molrudee Ekmahachai, Bannakij Lojanapiwat
Format: Journal
Published: 2018
Online Access:https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84878221214&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/48182
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-481822018-04-25T08:48:38Z Excretory urography and renal scintigraphy for chronic obstructed kidney: Does nonopacity mean nonsalvageability? Alisa Klaipetch Sirianong Namwongprom Molrudee Ekmahachai Bannakij Lojanapiwat Introduction This study aimed to ascertain whether nonopacified kidney on excretory urography (also known as intravenous urography [IVU]) indicates nonsalvageability. Methods We retrospectively reviewed 45 adult patients with chronic unilateral urinary tract obstruction, in whom IVU revealed nonopacified kidney on one side but normal excretion on the contralateral side. Affected kidneys with split glomerular filtration rate (GFR) < 10 mL/min/1.73 m 2 on 99m Tc-diethylenetriaminepentaacetic acid diuretic renal scintigraphy were considered nonsalvageable. Non-function was defined based on cutoff points ( < 15% and < 20%) to determine the sensitivity and specificity of differential renal function. Differences in IVU and renal scintigraphy findings, with respect to the duration of delayed filming on IVU, were analysed for significance. Results The results of IVU and renal scintigraphy findings for 34 (75.6%) nonopacified kidneys matched, representing nonsalvageable kidneys. Sensitivity and specificity of differential renal function were 76% and 100%, respectively, when the cutoff point for non-function was set at < 15%. Sensitivity and specificity were 97% and 82%, respectively, when the cutoff point was < 20%. There was no significant difference between renal scintigraphy findings and IVU with 2-hour and > 2-hour delayed films (p = 0.96). Conclusion Although most nonopacified kidneys on IVU were nonsalvageable, a quarter of them were found to be salvageable on renal scintigraphy. Besides split GFR, differential function at cutoff point < 15% could be used to determine non-function of a chronic obstructed kidney when the contralateral kidney is normal. Delayed filming beyond two hours appears unnecessary in ensuring non-excretion on IVU. 2018-04-25T08:48:38Z 2018-04-25T08:48:38Z 2013-01-01 Journal 00375675 2-s2.0-84878221214 10.11622/smedj.2013106 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84878221214&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/48182
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
description Introduction This study aimed to ascertain whether nonopacified kidney on excretory urography (also known as intravenous urography [IVU]) indicates nonsalvageability. Methods We retrospectively reviewed 45 adult patients with chronic unilateral urinary tract obstruction, in whom IVU revealed nonopacified kidney on one side but normal excretion on the contralateral side. Affected kidneys with split glomerular filtration rate (GFR) < 10 mL/min/1.73 m 2 on 99m Tc-diethylenetriaminepentaacetic acid diuretic renal scintigraphy were considered nonsalvageable. Non-function was defined based on cutoff points ( < 15% and < 20%) to determine the sensitivity and specificity of differential renal function. Differences in IVU and renal scintigraphy findings, with respect to the duration of delayed filming on IVU, were analysed for significance. Results The results of IVU and renal scintigraphy findings for 34 (75.6%) nonopacified kidneys matched, representing nonsalvageable kidneys. Sensitivity and specificity of differential renal function were 76% and 100%, respectively, when the cutoff point for non-function was set at < 15%. Sensitivity and specificity were 97% and 82%, respectively, when the cutoff point was < 20%. There was no significant difference between renal scintigraphy findings and IVU with 2-hour and > 2-hour delayed films (p = 0.96). Conclusion Although most nonopacified kidneys on IVU were nonsalvageable, a quarter of them were found to be salvageable on renal scintigraphy. Besides split GFR, differential function at cutoff point < 15% could be used to determine non-function of a chronic obstructed kidney when the contralateral kidney is normal. Delayed filming beyond two hours appears unnecessary in ensuring non-excretion on IVU.
format Journal
author Alisa Klaipetch
Sirianong Namwongprom
Molrudee Ekmahachai
Bannakij Lojanapiwat
spellingShingle Alisa Klaipetch
Sirianong Namwongprom
Molrudee Ekmahachai
Bannakij Lojanapiwat
Excretory urography and renal scintigraphy for chronic obstructed kidney: Does nonopacity mean nonsalvageability?
author_facet Alisa Klaipetch
Sirianong Namwongprom
Molrudee Ekmahachai
Bannakij Lojanapiwat
author_sort Alisa Klaipetch
title Excretory urography and renal scintigraphy for chronic obstructed kidney: Does nonopacity mean nonsalvageability?
title_short Excretory urography and renal scintigraphy for chronic obstructed kidney: Does nonopacity mean nonsalvageability?
title_full Excretory urography and renal scintigraphy for chronic obstructed kidney: Does nonopacity mean nonsalvageability?
title_fullStr Excretory urography and renal scintigraphy for chronic obstructed kidney: Does nonopacity mean nonsalvageability?
title_full_unstemmed Excretory urography and renal scintigraphy for chronic obstructed kidney: Does nonopacity mean nonsalvageability?
title_sort excretory urography and renal scintigraphy for chronic obstructed kidney: does nonopacity mean nonsalvageability?
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84878221214&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/48182
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