Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0035078 (renal failure)
 31,970 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effect of transient renal ischemia on renal concentration and distribution of 99mTc-HEDP, 99mTc-DMSA, and 99mTc-DTPA was compared in rabbits with acute tubular necrosis. Scintigrams were obtained after injection in normal rabbits or ones with unilateral or bilateral ischemia. 99mTc-HEDP concentration in ischemic tissue was 8 to 18 times normal 1--4 hours after injection, and the resulting images delineated the morphological changes in the ischemic kidneys more accurately than those obtained with DMSA or DTPA. Calcium concentration in the ischemic kidneys increased sixfold. 99mTc-HEDP may be useful in evaluation of renal failure secondary to tubular injury.
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PMID:Renal hyperconcentration of 99mTc-HEDP in experimental acute tubular necrosis. 22 Jun 70

Renal failure is an important cause of postoperative morbidity and mortality in infrarenal aortic reconstruction. Several mechanisms for this postoperative renal dysfunction have been suggested. However, biochemical testing of renal function is insensitive since it shows only gross renal changes. This study examined prospectively the effects of the technical and operative factors on renal function using radionuclide tests. The authors measured the total Glomerular Filtration Rate (GFR) using 51Cr-EDTA clearance in 59 patients undergoing elective infrarenal aortic reconstruction. We also examined the individual kidneys using 99mTc-DTPA renography and 99mTc-DMSA renal scanning. Renal scanning gives the percentage of function of each kidney, while renography gives a graphic assessment of individual renal perfusion and clearance. All tests were carried out preoperatively, 2 weeks postoperatively and 6 months later. Twelve technical factors including aortic cross clamping time, type of aortic anastomosis, forced diuresis, division of left renal vein and various others were recorded to study their effect on the GFR and the individual kidney function. The effect on renal function of these operative factors has not previously been described. GFR showed no change in the immediate postoperative period. Six months later GFR decreased, the mean decrease was 9 ml/min. (P = 0.007 Wilcoxon rank). Some of our patients showed an increased GFR, a phenomenon that was recognised recently. None of the factors studied, except division of the left renal vein, had any effect on the changes in the GFR in the immediate postoperative period or 6 months later.
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PMID:Technical and operative factors in infrarenal aortic reconstruction and their effect on the glomerular filtration rate in the immediate postoperative period and 6 months later. 235 21

Aprotinin (A) and DMSA labelled with 99mTc were compared in patients with normal (NK, n = 12) and diseased kidneys (CRF, n = 13) by means of quantitative serial scans and measurements of blood clearance and urinary excretion. Serial scans only were obtained in additional 13 patients. Scan quality in the NK patients was essentially equal: faster blood clearances, reduced urinary excretions and higher fixations of A in the target compensated for the increased liver uptake. On the other hand, the scan quality in the CRF patients was definitely superior with A, allowing detection of residual functioning parenchyma also in severe kidney failure. Correlation between the net kidney uptake 6 hrs p.i. and the separate hippuran clearance rate was better with A than with DMSA, indicating the feasibility of A in evaluating relative renal function.
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PMID:99mTc-aprotinin: comparison with 99mTc-DMSA in normal and diseased kidneys. 620 1

Aprotinin (Ap), a low-molecular-weight polypeptide (6500 dalton), is a protease inhibitor which is electively and stably accumulated in the kidney. In 112 adult patients, with either uni- or bilateral renal disease with different degrees of renal impairment (from normal GFR to advanced renal failure), renal scans were performed by means of Ap labelled with 99mTc. Highly satisfactory renal scans were obtained in all patients. In 20 patients with renal failure (serum creatinine 1.8-8.5 mg/dl, mean 4.7) a comparison was made of the renal scans obtained with 99mTc-Ap and with 99mTc-DMSA. 99mTc-Ap was slightly better than 99mTc-DMSA, especially in patients with far advanced renal failure. Some aspects of the pharmacokinetics of 99mTc-Ap were studied in 72 cases. In 22 of these patients plasma clearance of 99mTc-Ap was determined by the single injection method using a two-compartment model. In patients with GFR greater than 90 ml/min plasma clearance of 99mTc-Ap was 67.6 +/- 8.4 SD ml/min. A good correlation was observed between plasma clearance of 99mTc-Ap and GFR (r = 0.74). After IV injection 99mTc-Ap was stably fixed by the kidney. Renal radioactivity remained stable between the second and eighth hour after the injection. Urinary excretion of radioactivity measured in 35 patients in the first and in the second 2-h interval after IV injection of 99mTc-Ap was negligible in all patients (2.7 +/- 1.5 SD percent of the dose in the first 2 h; 2.8 +/- 1.4 SD between the second and fourth hour). 99mTc-Ap is an excellent agent for renal imaging. It also seems promising for renal function studies.
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PMID:99mTc-aprotinin: a new tracer for kidney morphology and function. 620 73

Some renal calculi are borderline indications for either extracorporeal shock wave lithotripsy (ESWL) or percutaneous nephrolithotomy (PCNL). Our purpose was to quantify by single photon emission computed tomography (SPECT) the parenchymal lesions of these two procedures to make the choice easier. The SPECT study was done before and 30 days after the stone treatment. The scan was carried out 10 hours after injection of 99mTc-DMSA using a GE400 rotative gamma camera, which data were reconstructed in three planes. The local uptake and scar of the treated area were evaluated in 22 patients with symptomatic kidney stones without previous treatment or renal failure. Twelve patients (mean stone size 12 x 9 mm) were treated on a piezoelectric (EDAP LT-01) lithotripter (mean shock wave number 3420), and ten patients (mean stone size 24 x 17 mm) were treated by PCNL (32F Amplatz sheath in a lower calix). There were no complications, and the stone-free rate at day 30 was 50% in both groups. In the ESWL group, all of the kidneys demonstrated a loss of local uptake, whereas 7 of the 10 in the PCNL group did so. In the ESWL group, 4 of the 12 kidneys had a local loss exceeding 4% but only 2 of 10 kidneys in the PCNL group. There were 7 scars in the treated area in the ESWL group and 6 in the PCNL group. Extracorporeal lithotripsy does not seem to be a nontraumatic procedure for the kidney. For stones that would require several sessions of ESWL, the use of PCNL must be preferred.
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PMID:Comparison by SPECT of renal scars after extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. 812 38

In Japanese patients idiopathic tubular proteinuria presents mainly as asymptomatic tubular low molecular weight proteinuria. This disease has recently been shown to resemble Dent's disease which is characterized by tubular proteinuria, hypercalciuria, rickets and eventual renal failure. We report on 4 children with idiopathic tubular proteinuria. Although they had normal renal function, as evidenced by serum creatinine or creatinine clearance, they had very poor renal accumulation of 99mTc-DMSA and the presence of large amounts of tracer in the bladder. Additionally, the patient with the largest amounts of tubular proteinuria had the poorest renal accumulation of the 4 patients. The renal accumulation of tracer decreased with time from a maximum at 10 min after injection. These findings demonstrate that the tracer, once taken to be confined to the proximal tubular cells, is immediately excreted to the tubular lumen. We suggest that poor renal accumulation of 99mTc-DMSA is very important in elucidating the mechanism of idiopathic tubular proteinuria, and that 99mTc-DMSA renoscintigraphy is useful in the evaluation of the patient's renal function over time.
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PMID:Poor renal accumulation of 99mTc-DMSA in idiopathic tubular proteinuria. 988 19

25 children (female) with urodynamically proven non-coordinated voiding were followed prospectively. The objective was to study the changes of urodynamic pattern and its clinical correlation after voiding reeducation and pharmacological treatment. All patients presented with urinary tract infections and voiding disfunction symptoms. 5 children had vesicoureteral reflux on voiding cystography and 10 patients had established scars on DMSA scan at initial presentation. Urodynamic study showed constriction of the urinary sphincter during voiding and increase of post-voiding residual urine volume in all children, with bladder instability 20 (80%). Treatment consisted of voiding reeducation, anticholinergics, antibiotic prophylaxis and muscle relaxants. The mean of follow-up was 22 months. Clinical remission occurred prior to urodynamic remission in all girls. Clinical recurrence was observed in 2 girls after cessation of treatment prior to normalization of urodynamic pattern. Non-coordinated voiding should be diagnosed and treated at pediatric age to avoid its possible progression to renal failure in other period of life.
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PMID:[Bladder with non-coordinated voiding: urodynamics and clinical correlations]. 1057 Aug 66

We reviewed Tc-99m DMSA scintigraphy in children with vesicoureteral reflux (VUR) in order to assess whether repeated Tc-99m DMSA scans are necessary for the follow up of these patients. Ninety-seven children who were followed up for more than one year (1-7.4 years, average 2.8 years) after the first DMSA scan were included in the study. Fifty-one patients had been diagnosed as primary VUR and 46 as secondary VUR. Age at the first examination ranged from 0 to 14 years (average 5.1 years). Planar images were taken 2 hours after injection. The % renal uptake per injected dose (%RU) was calculated from posterior images. Kidneys in 11 patients (11.3%) changed morphologically during the follow up. Of these, new photon deficient areas (PD) were detected in only 4 patients (4.1%). All of these 4 patients had neurogenic bladder and were managed with self-catheterization. Of the remaining 7 patients, cortical thinning progressed in 5 patients (5.2%) and PDs resolved in 3 patients (3.1%). In one of these 7 patients, PD resolved in one kidney and cortical thinning progressed in the contralateral kidney. Of 97 patients reviewed, % RU decreased more than 20% during the follow up in 6 patients (6.2%). All were diagnosed as secondary VUR due to neurogenic bladder. %RU decreased only in the contracted kidneys at the initial scan. Two of them underwent renal transplantation because of severe renal failure. In conclusion, new PD rarely developed and % RU decreased in only a few patients during the follow up of children with VUR. Repeated Tc-99m DMSA scintigraphy therefore seems to have little benefit in the follow up of children with VUR. It should be performed in selected patients with high risk of urinary tract infection or renal failure.
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PMID:Reappraisal of Tc-99m DMSA scintigraphy for follow up in children with vesicoureteral reflux. 1065 74

Five, 3-month-old mongrel dogs weighing between 4.5 to 5.5 kg were studied to evaluate and compare the efficiency of 99mTc-DTPA, 99mTc-MAG3, and 99mTc-DMSA in detecting gentamicin-induced renal tubular injury. After baseline renograms using all three methods, all dogs received daily intramuscular injections of gentamicin at a dose of 30-45 mg/kg. Additional studies were obtained after a cumulative dose of 450, 1,575, and 2,250 mg of gentamicin was reached. Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and percentage of total renal uptake measurements were calculated. Baseline and post-gentamicin injection blood urea nitrogen (BUN) and serum creatinine values were determined. A Duncan test revealed significant renal function impairment at 450 mgs of cumulated gentamicin with 99mTc-DMSA and at 1,575 mgs of cumulated gentamicin for 99mTc-DTPA and 99mTc-MAG3. There was no correlation between BUN and serum creatinine values when compared to gentamicin (p > 0.05). The images obtained with 99mTc-MAG3 were of better quality than those obtained with 99mTc-DTPA even under severe renal dysfunction. Percentage of 99mTc-DMSA uptake indicated renal damage, before than GFR and ERPF. BUN and serum creatinine measurements were poor indicators of gentamicin-induced renal failure.
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PMID:Quantitative and qualitative scintigraphic measurement of renal function in dogs exposed to toxic doses of Gentamicin. 1176 25

Extrarenal uptake of Tc-99m DMSA is not seen very often. It has previously been described in metastatic disease and was mainly attributed to the presence of V-DMSA in the injected solution. We report a clinical case of incidental visualization of metastatic bone disease of the colon in a patient with renal failure. This could be the result of not only the presence of V-DMSA, but also the renal failure and the atypia of the lesions.
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PMID:Tc-99m DMSA uptake by metastatic colorectal carcinoma. 1524 24


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