[Efficiency evaluation of diuretic renography in the operative or conservative treatments of unilateral ureteropelvic junction obstruction patients].
OBJECTIVE
To analyze the efficiency of diuretic renography in the management of unilateral ureteropelvic junction obstruction (UPJO) patients, by observing the affected kidney relative renal function (RRF) and drainage in the period of follow-up.


METHODS
In the study, 76 patients diagnosed as unilateral UPJO were retrospectively collected. Diuretic renography was performed on all the patients initially, and during the period of follow-up. No morphological or functional abnormalities were detected on the contralateral kidney. Changes of affected renal RRF and drainage were observed during the follow-up period. The correlations of initial RRF (RRFinitial) and drainage type with RRF improvement were analyzed.


RESULTS
In the operative group (57 cases), the RRFinitial of affected kidney was 40.81%±12.96%, and the RRF in the last follow-up (RRFrecent) was 44.63%±13.21% (P<0.05). Drainage improvements was found in 54.00% of the obstructive patients (27/50), and unchanged in 71.43% of the non-obstructive patients (5/7). In the conservative group (19 cases), the RRFinitial was 46.47%±12.84%, and the RRFrecent was 46.95%±11.86% (P>0.05). One obstructive patient (1/10) was found with improved drainage, and the other 9 obstructive patients (9/10) and all of the non-obstructive patients (9/9) were observed with unchanged drainage. Four patients with deteriorated RRF in the conservative group received surgery. There were no significant differences in the changes of affected renal RRF in different RRFinitial and drainage types in both operative and conservative groups.


CONCLUSIONS
Diuretic renography could be effectively applied in the follow-up of unilateral UPJO patients. Operation could improve affected kidney's RRF, and better some patients' drainage conditions. However, for those patients with no or minor clinical symptoms, conservative management could be accepted if RRF remains stable during the period of follow up.
Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China.
Meng
M
Liu
Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China.
Zhan-li
ZL
Fu
Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China.
Li-juan
LJ
Di
Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China.
Jian-hua
JH
Zhang
Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China.
Yan
Y
Fan
Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China.
Xu-chu
XC
Zhang
Department of Nuclear Medicine, Peking University First Hospital, Beijing 100034, China.
Rong-fu
RF
Wang
D004232:Diuretics; D006801:Humans; D006869:Hydronephrosis / Q000151:congenital* / Q000000981:diagnostic imaging; D007668:Kidney / Q000503:physiopathology; D021782:Multicystic Dysplastic Kidney / Q000000981:diagnostic imaging*; D011866:Radioisotope Renography; D012189:Retrospective Studies; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging*
D004232:Diuretics