Advertisement

Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Nephrography with radioactive hippuran in transplanted kidneys: Interpretation, limitations, and usefulness

Abstract

A total of 485 nephrographies (NGs) performed on 95 patients in 1982 were analyzed statistically. The different modes of orthoiodine-hippuran (OIH) handling by the transplanted kidneys are summarized by six different basic curve patterns. The formation of these patterns is an effect of the prolongation of the time to the curve maximum, the time to 75% of the maximum, and the time until the intersection of the bladder and kidney curves. Also, intraparenchymal retention of activity leads to changes in the OIH curves. The basic curve patterns were correlated with the increase of serum creatinine levels, and thus, OIH-NG has to be interpreted as a differentiated marker of renal function. Renal-transplant rejection does not produce a specific pattern of OIH curve, as seen from comparison of the curve-type distribution in rejection and non rejection periods (x 2=0.0866). The diagnostic values of the OIH is limited to purely functional statements, allowing only an indirect diagnosis of renal-transplant rejections without permitting the differential diagnosis of other causes of renal disturbance. OIH-NG is useful for monitoring renal function because it resolves different function levels very sensitively even at identical creatinine values. Furthermore, it makes it possible to estimate the prognosis of renal functional improvement when creatinine levels are elevated.

This is a preview of subscription content, log in to check access.

References

  1. Berger H, Kleinhans E, Moser E, Büll U, Land W (1980) Die 99mTc-DTPA-Perfusionsszintigraphie zur Funktionskontrolle bei Nierentransplantation. Nucl Med 19:263–270

  2. Bischof-Delaloye A, Wauters JP, Brunner HR, Delaloye B (1980) Appreciation of renal function by OIH with the scintillation camera after kidney transplantation. II. Medical radionuclide imaging. Proceedings of a symposium organized by the IAEA in co-operation with the WHO, Heidelberg, 1–5 September, 1980. International Atomie Energy Agency, Vienna, pp 377–385

  3. Britton KI, Brown NJG (1971) Clinical renography. Lloyd-Luke, London, pp 28–43

  4. Civati G, Banfi F, Barbiano di Belgioioso G (1978) Employment of the gammacamera in the early surveillance of the transplanted kidney. Minerva Nefrol 25:347–352

  5. Clorious JH, Dreikorn K, Zelt J, Raptou E, Weber D, Rubinstein K, Drahm D, Georgi P (1979) Renal graft evaluations with pertechnetate and 131I-hippuran. A comparative clinical study. J Nucl Med 20:1029–1037

  6. Dienstl E, Kramar R, Herbinger W (1977) Sequenzscintigraphie und Kameranephrographie zur Verlaufskontrolle nach Nierentransplantation. Wien Med Wochenschr 127:374–376

  7. Diethelm AG, Dubovsky EV, Whelchel JD (1980) Diagnosis of impaired renal function after kidney transplantation using renal scintigraphy, renal plasma flow and urinary excretion of hippurate. Ann Surg 191:604–616

  8. Dubovsky EV, Logic JR, Diethelm AG, Balch CM, Tauxe WN (1975) Comprehensive evaluation of renal function in the transplanted kidney. J Nucl Med 16:1115–1126

  9. Dubovsky EV, Diethelm AG, Tauxe WN (1977) Differentiation of cell mediated and humoral rejection by orthohippurate kinetics. Arch Intern Med 137:738–742

  10. Eigler J (1978) Die akute Abstoßungsreaktion nach Nierentransplantation — diagnostische und therapeutische Aspekte. Med Klin 73:1682–1689

  11. Fill H (1981) Die Bedeutung der Nuklearmedizin für die Akutdiagnostik in Nephrologie und Urologie. Nuklearmedizin 20:305–309

  12. Fill H, König P, Spielberger M, Margreiter R, Dumfahrt H, Zechmann W (1982) Morphological signs of acute transplant rejection in the renogram (RG) and hippuran serial scintigram (HSS). Nuklearmedizin (suppl) 19:730–732

  13. Hausen A, Fuchs D, König K, Wachter H (1982) Determination of neopterin in human urine by reversed-phase high performance liquid chromatography. J Chromatogr 227:61–70

  14. Häyry P, von Willebrand E (1981) Monitoring of human renal allograft rejection with fine needle aspiration cytology. Scand J Immunol 13:87–97

  15. Kenny RW, Achery DM, Fleming JS, Goddard BA, Grant RW (1975) Deconvolution analysis of the scintillation camera renogram. Br J Radiol 48:481–486

  16. Laasonen L, Kock B (1978) Angiography and isotope renography in acute rejection of renal transplants. Scand J Urol Nephrol 12:79–82

  17. Leisner B, Grau M, Held E (1979) Comparison of the value of different parameters in the diagnosis of renal transplant function. Nieren Hochdruckkr 8:98–105

  18. Manalich-Comas R, Romero-Chacon N, Iglesias-Llanios J, Rico-Fragoso M (1978) Renal radioisotope scanning using O-iodohippurate sodium during the immediate post transplantation period. The use of a rectilinear radioisotope scanning. Rev Cubana Med Trop 17:111–116

  19. Mandel SR, Mattern WD, Staab E, Johnson G (1972) Use of radionuclide imaging in the early diagnosis and treatment of renal allograft rejection. Ann Surg 181:596–603

  20. Margreiter R, Fuchs D, Hausen A, Huber C, Reibenegger G, Spielberger M, Wachter H (1983) Neopterin as a new biochemical marker for diagnosis of allograft rejection. Transplantation 36:650–653

  21. Marks DS (1978) Radionuclide evaluation of renal transplant patients. Henry Ford Hosp Med J 26:19–26

  22. Pabst HW (1965) Isotopendiagnostik von Nierenkrankheiten. München Med Wochenschr 34:1581–1590

  23. Pabst HW, Hör G (1978) Nephrologie und Urologie. In: Diethelm L, Hauck F, Olsson O, Strnad F, Vieten H, Zuppinger A (eds) Handbuch der medizinischen Radiologie. Nuklearmedizin, vol 2. Springer, Berlin Heidelberg New York, pp 509–538

  24. Preston DF, Luke RG (1979) Radionuclide evaluation of renal transplant. J Nucl Med 20:1095–1097

  25. Reitamo T, Laasonen L, Kock B, Edgren J (1979) Urography and isotope renography following renal transplantation. Scand J Urol Nephrol 13:283–285

  26. Roedler HD, Kaul A, Hine GJ (1978) Internal radiation dose in diagnostic nuclear medicine. H. Hoffmann, Berlin, pp 64–75

  27. Rollo FD, Jones JP, Price RR, Patton JA, Erikson JJ, Born M, Touya JJ (1980) Automated renogram analysis for bilateral and transplant renograms: generating time-activity curves. Gamma-11 clinical applications package, vol 1. Digital equipment corporation, Marlboro, p 5

  28. Rösler H (1967) Die Bestimmung der 131I-Ortho-Iodhippursäure-Totalclearance. Dtsch Med Wochenschr 92:881–887

  29. Sato K (1977) Diagnostic significance of angiography, renography and scintiphotography after renal transplantation. Hirosaki Med J 29:61–92

  30. Schneider G, Scholz D, Strangfeld D, Koschorek H, Bretschneider H, Gorka H (1978) Aussagemöglichkeit des ING zur Erfassung von Komplikationen nach Nierentransplantation. Radiol Diagn (Berl) 19:99–100

  31. Singh A, Cohen WN (1980) Renal allograft rejection: sonography and scintigraphy. Am J Roentgenol Radium Ther Nucl Med 135:73–77

  32. Strötges MW, Schmitt G, Hartmann HG (1977) Nuklearmedizinische Untersuchungsverfahren bei der Überwachung von Patienten mit Nierentransplantaten. Nucl Med 16:207–213

  33. Tapia L, Cahill P, McGovern R, Reid-Sterret J, Lubin AL (1978) Changes in intrarenal transplant kinetics of 131I hippuran (OIH) associated with rejection. Kidney Int 4:799

  34. Weeden RP (1969) Autoradiography of hippuran 125I in rat kidney: the intrarenal basis of the radioisotope renogram. In: Timmermans L, Merchie G (eds) Radioisotopes in the diagnosis of diseases of the kidneys and the urinary tract. International Congress Series, no 178. Excerpta Medica, Amsterdam, pp 461–466

  35. zum Winkel K, Hallwachs O, Steinhausen M (1968) Kamerascintigraphie und Isotopennephrographie an der Hundeniere und deren Überprüfung durch die Intravitalmikroskopie. Fortschr Geb Rontgenstr. Nuklerarmed Erganzungsband 108:382–392

Download references

Author information

Correspondence to Dr. H. Fill.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Fill, H., Spielberger, M., Leidlmair, K. et al. Nephrography with radioactive hippuran in transplanted kidneys: Interpretation, limitations, and usefulness. Eur J Nucl Med 11, 171–178 (1985). https://doi.org/10.1007/BF00251369

Download citation

Key words

  • Kidney transplant
  • Nephrography
  • Radioactive hippuran
  • Rejection
  • Prognosis of transplant function