Congenital or early developmental versus later acquired renal function asymmetry. Scintigraphic characteristics.
A congenitally or developmentally small right kidney in an adult spinal cord injury patient had only 12% of total uptake on radioiodine-labeled orthoiodohippurate renography but nevertheless had a normal-shaped time-activity curve. In a subsequent retrospective review of 175 consecutive radioiodine-labeled orthoiodohippurate renograms performed on adult patients over a 3-year period, 35 other patients with studies showing greater than 2:1 asymmetry in renal function were identified. Uptake, clearance, or both were abnormal in all 35 kidneys with less than 33.3% of function, with the left kidney more commonly affected (n = 24). Correlation from ultrasound, computerized tomography, intravenous pyelography, and angiography demonstrated acquired abnormalities associated with all 35 of these kidneys, including urinary obstruction (n = 20), renal artery stenosis (n = 9), and cortical scarring/infection and/or reflux (n = 15) (some patients had more than one diagnosis). While acquired renal function asymmetry almost always results in a smaller kidney with abnormal uptake or clearance characteristics, a congenitally small kidney may have overall reduced blood flow but still display a normal-shaped time-activity curve on radionuclide renography.
Whitley
M A
MA
Nuclear Medicine Section, Department of Veterans Affairs Medical Center, Seattle, Washington 98108.
Jacobson
A F
AF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D007465:Iodohippuric Acid; D007668:Kidney / Q000002:abnormalities* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011866:Radioisotope Renography; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology
D007457:Iodine Radioisotopes; D007465:Iodohippuric Acid