Changes in renal cortical and medullary perfusion in a patient with renal vein thrombosis.
Dynamic renal perfusion computerized tomographic (CT) scan was performed to test the cortical and medullary perfusion in a patient with unilateral renal vein thrombosis secondary to idiopathic focal and segmental glomerulosclerosis (FSGS). Forty mL of Iohexol was injected intravenously. Multiple fixed repeated axial renal CT scan cuts at specific intervals, over the mid pole, were recorded over 400 seconds. Radio density was measured over the aorta, cortex and medulla during that period. Graphs for the radio contrast density against time were plotted. Aortic, cortical and medullary perfusions were calculated by estimating the slopes of the curves. Based on the CT scan findings, perfusion of different parts of the kidney was measured. The reduction in kidney function with renal vein thrombosis seems to be secondary to hypoperfusion of renal cortex and medulla. Further studies are required to confirm this observation. The blood flow to the kidney im-proved within four days after therapy with anticoagulation and pulse steroids. The sequences of events that take place need further studies for validation.
Al-Said
Jafar
J
Department of Nephrology, Bahrain Specialist Hospital, Manama, Bahrain. jafaralsaid@netscape.net
Kamel
Olfat
O
D000925:Anticoagulants / Q000627:therapeutic use; D003287:Contrast Media / Q000008:administration & dosage; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology; D006801:Humans; D007275:Injections, Intravenous; D007472:Iohexol / Q000008:administration & dosage; D007672:Kidney Cortex / Q000098:blood supply*; D007679:Kidney Medulla / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods; D020551:Pulse Therapy, Drug; D012079:Renal Circulation; D012082:Renal Veins / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013256:Steroids / Q000008:administration & dosage; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology*
D000925:Anticoagulants; D003287:Contrast Media; D013256:Steroids; D007472:Iohexol