Evaluation of renal function in obstructive nephropathy by I.V.U versus isotope renal scan

Abstract

The study is performed prospectively conducted at radioisotope center in Khartoum, RICK. 75 cases of different age groups of obstructive uropathy was selected whose diagnosed by IVU in different centers, Male (48) 64% ,Female ((27) 36%. The onset of presentation was acute (2) 2.7% , chronic (66) 88.0% , acute on chronic (7) 9.3% . The radio opaque shadows was seen as a cause of obstruction in(52) 69.3%, and not seen in (23) 30.7% .The radio opaque shadows was Single in (32)42.7%, Multiple in (20)26.7%. The IVU shows (40)53.3% with non functioning kidneys, the remaining (35)46.7% were different grades of obstruction. The ureter was normal in (40) 53.3%, dilated in (2) 2.7%, Not seen in (33) 44.0%. The bladder was Normal in (75)100%. Forty percent (53.3% non-visualizing kidneys on excretory urography were studied with Tc99m scintiscanning. In (29)38.7% no blood flow , in (11)14.7% little blood flow were demonstrated on nucleide scanning. The relative perfusion was 1-10.9% in (14)18.7% patients, 11-20.9% in (15)20.0%, 21-30.9% in (7)9.3% , 31-40.9% in (3)4.0% & 41-50.9% in (1)1.3% patient. The relative function was less than 1% in (3)4.0%patients, 1-10.9% in (30)40.0%, 11-20.9% in (5)6.7% & 21-30.9% in (2)2.7% patients. Different grades of obstructive uropathy were studied ; In (2)2.7% grade 1 show normal blood flow and relative perfusion of 41-50.9% and 51-60.9%, while relative function were 41-50.9% and 51-60.9% respectively. In 7 cases of grade 2; (4)5.3% patients show normal blood flow, (3)4.0% show moderate blood flow, (2)2.7% show relative perfusion 31-40.9%, (4)5.3% relative perfusion 41-50.9% and (1)1.3% relative perfusion 51-60.9%, Relative function show 31-40.9% in (3)4.0%, 41-50.9% in (2)2.7% patients & 61-70.9% in (2)2.7% patients. In 21 cases of grade 3; (10)13.3% show little blood flow and (11)14.7% moderate blood flow. The relative perfusion shows 21-30.9% in (8)10.7% patients, 31-40.9% in (6)8.0% patients, 41-50.9% in (4)5.3% patients and 51-60.9% in (3)4.0% patients. The relative function shows 11-20.9% in (6)8.0% patients, 21-30.9% in (6)8.0% patients, 31- 40.9% in (8)10.7% patients & 41-50.9% in (1)1.3%patient. In 8 cases of grade 4; (7)9.3% show little blood flow and (1)1.3% moderate blood flow, (5)6.7% patients show relative perfusion of 21-30.9%, in (3)4.0% patients is 31-40.9%. The relative function is 1-10.9% in (4)5.3% patients, 11-20.9% in (3)4.0% patients, 31-40.9% in (1)1.3% patient.