Since 1954. radioisotope renography has been performed as a useful kidney function test in the urological field The author using Hypaque-I which has no liver interference, performed radioisotope renography on 25 cases, in which 10 cases of normal, 5 cases of obstructive uropathy, 7 cases of renal dysfunction, 1 case of acute glomerulonephritis and 2 cases of hypertensive uropathy were included In the normal cases, the Hypaque-I renogram has 3 typical segments, namely vascular segment, functional segment and evacuation phase. The vascular segment begins 8~20 seconds after a rapid intravenous injection of Hypaque-I, lasting 30-40 seconds and occurs the functional segment. The functional segment is completed within 3~10 minuets, having a peak And then, the evacuation phase appears, inclining down rapidly. In the renogram of obstructive uropathy, the vascular and functional segments are almost normal together, but the evacuation phase is either prolonged or increased In the renogram of renal dysfunction, the vascular segment is not only reduced, but also the functional segment is low and the evacuation phase shows a dull inclining curve. In the renogram of acute glomerulonephritis, shows no changes of each segment. The renogram of hypertensive uropathy represents the remarkably lower vascular and functional segments and evacuation phase than those of renal dysfunction. The Hypaque-I renogram has many practical advantage, offering rapid and immediate results, being easily performed, being non-traumatic and innocuous, making each kidney to be tested separately, being able to be repeated frequently, and being free from any preparation and anesthesia of patients.
Anesthesia ; Glomerulonephritis ; Humans ; Injections, Intravenous ; Kidney ; Kidney Function Tests ; Liver ; Radioisotope Renography

The 128 patients (78 males, 50 females) managed in the Nephrology Department, Chî RÉy hosptial, were enrolled in this study to compare the classical clearance creatinine 24h with the clearance creatinine estimated by Cockcroft Gault formula. Almost 2/3 patients had glomerular diseases, in which the majority was manifested by the nephritic syndrome. The range of clearance creatinine 24h varied from 0.02 ml/min to 131 ml/min. A good correlation between clearance creatinine/1.73m2 in 24h and estimated clearance creatinine/1.73m2 from Cockroft Gault formula (r=0.89, R2=0.8, p<0.0005), a regression line was drawn. There had a strong correlation in the subgroup of female and subgroup with serum creatinine (3mg% (r=0.985). In conclusion, the Cockroft Gault formula estimated clearance creatinine can be replaced the classical clearance 24h on the evaluation of kidney function in renal disease patients
Kidney ; Kidney Function Tests

INTRODUCTIONThis study aimed to ascertain whether nonopacified kidney on excretory urography (also known as intravenous urography [IVU]) indicates nonsalvageability.

METHODSWe retrospectively reviewed 45 adult patients with chronic unilateral urinary tract obstruction, in whom IVU revealed nonopacified kidney on one side but normal excretion on the contralateral side. Affected kidneys with split glomerular filtration rate (GFR) < 10 mL/min/1.73 m2 on 99mTc-diethylenetriaminepentaacetic acid diuretic renal scintigraphy were considered nonsalvageable. Non-function was defined based on cutoff points (< 15% and < 20%) to determine the sensitivity and specificity of differential renal function. Differences in IVU and renal scintigraphy findings, with respect to the duration of delayed filming on IVU, were analysed for significance.

RESULTSThe results of IVU and renal scintigraphy findings for 34 (75.6%) nonopacified kidneys matched, representing nonsalvageable kidneys. Sensitivity and specificity of differential renal function were 76% and 100%, respectively, when the cutoff point for non-function was set at < 15%. Sensitivity and specificity were 97% and 82%, respectively, when the cutoff point was < 20%. There was no significant difference between renal scintigraphy findings and IVU with 2-hour and > 2-hour delayed films (p = 0.96).

CONCLUSIONAlthough most nonopacified kidneys on IVU were nonsalvageable, a quarter of them were found to be salvageable on renal scintigraphy. Besides split GFR, differential function at cutoff point < 15% could be used to determine non-function of a chronic obstructed kidney when the contralateral kidney is normal. Delayed filming beyond two hours appears unnecessary in ensuring non-excretion on IVU.

Adult ; Aged ; Aged, 80 and over ; Chronic Disease ; Female ; Glomerular Filtration Rate ; Humans ; Kidney ; diagnostic imaging ; Kidney Diseases ; diagnostic imaging ; therapy ; Kidney Function Tests ; Male ; Middle Aged ; Pentetic Acid ; Radioisotope Renography ; methods ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Technetium ; Treatment Outcome ; Ureteral Obstruction ; diagnostic imaging ; therapy ; Urography ; methods

This study was conducted to assess the relationship between estimated glomerular filtration rate (eGFR) and bone mineral density (BMD) in Korean postmenopausal women with mild renal dysfunction. A total of 328 postmenopausal women who underwent BMD measurement during health check-up was investigated. BMD was measured in lumbar spine (L1-L4), femoral neck, total proximal femur and femoral trochanteric areas by dual energy radiography absorptiometry and renal function was estimated by eGFR using Cockcroft-Gault equation. Of the 328 subjects, 317 (96.6%) had an eGFR > or =60 mL/min/1.73 m2. By using simple linear regression analysis, age, height, weight and eGFR were significantly associated with BMD for the 4 aforementioned anatomic sites, while serum levels of creatinine and blood urea nitrogen did not influence BMD. When multiple regression analyses were applied, age and body weight still had significant associations with BMD at 4 different anatomic sites (P < 0.001). A significant association of eGFR with BMD remained in the lumbar spine, femoral neck and proximal total femur (P < 0.05) but not in the trochanteric area (P = 0.300). Our study suggests that a decline of renal function is associated with lower BMD in the lumbar spine, femoral neck and total proximal femur areas in Korean menopausal women with mild renal dysfunction.
Absorptiometry, Photon ; Aged ; Blood Urea Nitrogen ; *Bone Density ; Creatinine/blood ; Female ; Femur Neck/physiology ; *Glomerular Filtration Rate ; Humans ; Kidney Diseases/*physiopathology ; Kidney Function Tests ; Lumbar Vertebrae/physiology ; Middle Aged ; Osteoporosis, Postmenopausal/*physiopathology ; Republic of Korea

PURPOSE: Simple cysts are a common structural abnormality in seemingly healthy individuals, but their clinical significance, especially on changes of renal function, remains unknown. We examined whether sporadic cysts can influence changes of renal function in apparent healthy individuals. METHODS: The records from 424 people who underwent two ultrasonographic examinations in a routine check-up at our health promotion center from 2000 to 2003 were reviewed. Patients who had a medical disease were excluded. The healthy individuals (n=199) were divided into two groups according to whether they had renal cysts (cyst group, n=61), or not (control group, n=138). Renal function was evaluated by serum creatinine level (Scr), creatinine clearance (Ccr), using the Cockcroft-Gault equation, and glomerular filtration rate (GFR), using the MDRD equation. RESULTS: Individuals in the cyst group were significantly older (44.18+/-7.55, 41.02+/-7.06, p=0.013) and more likely to be male (90.16%, 72.46%, p=0.006) than those without cysts. Compared with the control group, the cyst group had no significant differences in Scr (1.03+/-0.15 mg/dL, 1.08+/-0.11 mg/dL, respectively, p=0.06), in Ccr (82.34+/-13.26 ml/min, 81.00+/-12.6 ml/min, respectively, p=0.56) nor in GFR (84.35+/-11.65 ml/min/1.73m2, 82.47+/-10.27 ml/min/1.73m2, respectively, p=0.38). Furthermore, the parameters for changes of renal function were not significant over three years. Conclusions:The presence of renal cysts was associated with neither renal dysfunction nor a reduction in renal function over three years in Korean individuals without apparent renal disease.
Creatinine ; Glomerular Filtration Rate ; Health Promotion ; Humans ; Kidney Diseases ; Kidney Function Tests ; Male

To explore the effect of Kudiezi injection on renal function in the real world, in order to provide the basis for the clinical medication safety. Patient aged between 18-80 were selected from 18 large hospitals information system (HIS) databases established by clinical research institute for basic traditional Chinese medicine of China academy of Chinese medical sciences. The patients who were treated with Kudiezi injection (24 225 cases) were defined as the exposed group, whereas those who were not treated with Kudiezi injection (14,191 cases) were defined as the non-exposed group. The propensity score method was used to balance the confounding factors. Classic logistic regression, GBM weighted propensity score logistic regression, GBM propensity score weighted logistic regression with covariate and sensitivity analysis were adopted to study the effect of Kudiezi injection on renal function. The results showed no significant difference in the possibility in abnormality in serum creatinine (Scr) (P = 0.940, 0.679, 0.834) and urea nitrogen (BUN) (P = 0, 0.045, 0.164) between both groups. Therefore, the existing data indicated no damage of Kudiezi injection on renal function. Because this study is a retrospective study based on the real world, there may be unknown confounding factors and potential bias. Therefore, further studies shall be conducted to monitor whether Kudiezi injection causes damage on renal function, in order to ensure the clinical medication safety.
Blood Urea Nitrogen ; Drugs, Chinese Herbal ; adverse effects ; Hospital Information Systems ; Humans ; Injections ; Kidney ; drug effects ; physiology ; Kidney Function Tests ; Logistic Models ; Propensity Score ; Retrospective Studies

PURPOSE: We evaluated the incidence and impact of vesico-ureteral reflux(VUR) on renal function after a radical cystectomy and the use of orthotopic bladder substitutes, using refluxing and antirefluxing type uretero-intestinal anastomosis. MATERIALS AND METHODS: Sixty-five patients(124 renal units) had undergone a radical cystectomy with an ileal orthotopic substitute and received postoperative follow-up for longer than 12 months. For these patients, we evaluated the presence and grade of VUR using voiding cystourethrography(VCUG) and measured the individual glomerular filtration rate (GFR) of the corresponding renal units using a (99m)technetium diethylenetetraminepentaacetic acid(DTPA) renal scan. According to the urinary diversion(refluxing or antirefluxing methods), we analyzed the incidence of VUR and the impact of VUR on renal function. The mean follow-up time was 52 months(range 13-132 months) after surgery. RESULTS: The incidence of VUR was higher in the refluxing anstomosis group(group R, 60.3%) of patients than in the antirefluxing group of patients(group NR, 21.7%)(p=0.001). However, the mean GFR was not significantly different(72.5ml/min/m2 for group R patients, 76.4ml/min/ m2 for group NR patients, respectively). Between the refluxing and nonrefluxing renal units, no significant difference of GFR was also noted (38.3ml/min/m2 versus 37.7ml/min/m2). When GFR was stratified by the duration of the diversion, it was not significantly different (38.2, 36.2, and 41.7ml/min/m2 at 12-24, 25-48 and > 48 months, p>0.05, respectively) regardless of the diversion methods. The degree of reflux was not related to the renal function. CONCLUSIONS: Although there was a higher incidence of VUR in the refluxing type than in the antirefluxing type of orthotopic bladder substitutes, VUR developing after a radical cystectomy does not significantly alter renal function regardless of its severity or the methods and duration of the diversion.
Cystectomy* ; Follow-Up Studies ; Glomerular Filtration Rate ; Humans ; Incidence ; Kidney Function Tests ; Urinary Bladder Neoplasms ; Urinary Bladder* ; Vesico-Ureteral Reflux*

OBJECTIVETo observe the effect of Cordyceps sinensis (CS) powder on renal oxidative stress and mitochondria functions in 5/6 nephrectomized rats, and to primarily explore its possible mechanisms.

METHODSTotally 30 male Sprague-Dawley rats were divided into the sham-operation group, the model group, and the treatment group by random digit table, 10 in each group. A chronic kidney disease (CKD) rat model was prepared by one step 5/6 nephrectomy. Rats in the treatment group were intragastrically administered with CS powder solution at the daily dose of 2 g/kg, once per day. Equal volume of double distilled water was intragastrically administered to rats in the sham-operation group and the model group. All medication lasted for 12 weeks. The general condition of rats, their body weight, blood pressure, 24 h proteinuria, urinary N-acetyl-β-D-glucosaminidase (NAG), serum creatinine (SCr) , and blood urea nitrogen (BUN) were assessed before surgery, at week 2, 4, 6, 8, 10, and 10 after surgery. Pathological changes of renal tissues were observed under light microscope. Morphological changes of mitochondria in renal tubular epithelial cells were observed under transmission electron microscope. Activities of antioxidant enzymes including reduced glutathione (GSH), manganese superoxide dismutase (MnSOD), and malondialdehyde (MDA) in fresh renal tissue homogenate were detected. Mitochondria of renal tissues were extracted to detect levels of mitochondrial membrane potential and changes of reactive oxygen species (ROS). And expressions of cytochrome-C (Cyto-C) and prohibitin in both mitochondria and cytoplasm of the renal cortex were also measured by Western blot.

RESULTS(1) Compared with the sham-operation group, body weight was significantly decreased at week 2 (P <0. 01), but blood pressure increased at week 4 (P <0. 05) in the model group. Compared with the model group, body weight was significantly increased at week 12 (P <0. 01), but blood pressure decreased at week 8 (P < 0. 01) in the treatment group. (2) Compared with the sham-operation group, 24 h proteinuria, urinary NAG, blood SCr and BUN significantly increased in the model group (all P <0. 01). Compared with the model group, blood and urinary biochemical indices all significantly decreased in the treatment group (all P <0. 01). (3) Results of pathological renal scoring: Glomerular sclerosis index, scoring for tubulointerstitial fibrosis, degree of tubulointerstitial inflammatory infiltration were all obviously higher in the model group than in the sham-operation group (all P <0. 01). All the aforesaid indices were more obviously improved in the treatment group than in the model group (all P <0. 01). (4) Compared with the sham-operation group, activities of MnSOD and GSH-Px were significantly reduced, but MDA contents obviously increased in the renal cortex of the model group (all P <0. 01). Compared with the model group, activities of MnSOD and GSH-Px obviously increased (P <0. 05, P <0. 01), but MDA contents obviously decreased in the renal cortex of the treatment group (P <0. 01). (5) Compared with the sham-operation group, the mitochondrial membrane potential significantly decreased, but ROS levels significantly increased in the model group (all P <0.01). Compared with the model group, mitochondrial transmembrane potential increased in the treatment group, thereby inhibiting the tendency of increased production of ROS (both P < 0. 01). (6) Results of Western blot showed that, compared with the sham-operation group, expression levels of mitochondrial Cyto-C and Prohibitin were significantly reduced in the renal cortex (P <0. 01), but significantly elevated in the cytoplasm of the model group (P <0. 01). Compared with the model group, each index was obviously improved in the treatment group with statistical difference (P <0. 05, P <0. 01).

CONCLUSIONCS powder had renal protection, and its mechanism might partially depend on in- hibition of oxidative stress and protection for mitochondria.

Acetylglucosaminidase ; metabolism ; Animals ; Blood Urea Nitrogen ; Cordyceps ; Drugs, Chinese Herbal ; pharmacology ; Kidney ; Kidney Cortex ; Kidney Diseases ; Kidney Function Tests ; Male ; Malondialdehyde ; metabolism ; Mitochondria ; Nephrectomy ; Oxidative Stress ; drug effects ; Proteinuria ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism

BACKGROUNDLiving donor kidney transplantation (LKT) has been booming in China. This study aimed to elucidate the renal function of both Chinese donors and recipients after the donation and transplantation.

METHODSOne hundred and forty-one pairs of donors and recipients for LKT were randomly selected and followed up for up to seven years. The donors' and recipients' renal function was recorded before and after operation.

RESULTSThe donors presented a mean age of (43.9 ± 7.5) years at donation. The female contributed 101/141 (71.6%) in all donors, and no effect was shown between genders on healthy donors' renal function. The donors' glomerular filtration rates (GFR) were (119.5 ± 20.4) ml/min, (85.2 ± 17.6) ml/min, (87.2 ± 15.9) ml/min, (82.1 ± 14.6) ml/min and (83.0 ± 13.7) ml/min preoperatively, and for five days, three months, one year and beyond one year after the operation. The donors for the period of 1 - 3 years, 3 - 5 years and more than 5 years after donation showed GFR as (83.9 ± 12.7) ml/min, (83.0 ± 17.6) ml/min, and (80.9 ± 20.8) ml/min, respectively, no statistically significant difference was found. Moreover, no significant clinical changes in blood pressure and proteinuria were found among the donors. In the recipients, delayed graft function (DGF) rate was 6.4%, acute rejection rate was 11.3%, and GFR were (66.5 ± 16.4) ml/min, (73.2 ± 19.6) ml/min and (63.9 ± 18.6) ml/min respectively at three months, one year and beyond one year post-transplantation respectively.

CONCLUSIONThe donors/recipients of LKT in Chinese population experience well-functioning remaining/donor kidneys.

Adult ; Aged ; Blood Pressure ; physiology ; China ; Cohort Studies ; Female ; Glomerular Filtration Rate ; physiology ; Humans ; Kidney Function Tests ; Kidney Transplantation ; Living Donors ; Male ; Middle Aged ; Postoperative Period ; Proteinuria ; physiopathology

OBJECTIVEAccurate and reliable assessment of renal function is important in the management of children with chronic kidney disease (CKD). Glomerular filtration rate (GFR) is the best index of assessing kidney function. For assessment of GFR, both gold standard tests and prediction equations have been used. The well-known 24-hour endogenous creatinine clearance (Ccr), the Schwartz formula and the Filler formula are increasingly used in daily clinical practice. However, there are few studies on the applicability of these prediction equations for estimating GFR in Chinese children with CKD. The aim of this study was to compare these prediction equations estimating GFR with an isotope clearance method [isotope glomerular filtration rate (rGFR)] in such patients.

METHODChildren aged 1-16 years who underwent isotope (99m)Tc-diethylenetriaminepentaacetic acid ((99m)Tc-DTPA) GFR testing (Gates' method) between the year of 2002 and 2005 were studied retrospectively. GFR was estimated using: (1) 24-hour Ccr, which was calculated using the standard formula: [urine creatinine (milligrammes per millilitre) × 24-hour urine volume/serum creatinine (milligrammes per millilitre) × 1440] × [1.73 (m(2))/body surface area (m(2))]; (2) the Schwartz formula, which is: eGFR (ml/min per 1.73 m(2)) = k × height (centimetres)/serum creatinine (micromoles per litre), where k is 62 in males at 13 years of age and older, 40 in infants, and 49 in all other children; and (3) the Filler formula, which is: logGFR = 1.962 + [1.123 × log(1/Cys C)], where cystatin C is measured in milligrammes per litre. Serum and urinary creatinine levels were detected by alkaline kinetic method. Serum cystatin C was analysed by particle-enhanced immunoturbidimetric assay. Bias and precision were evaluated.

RESULTThirty subjects (18 males and 12 females; mean age 9.4 years) fulfilling both inclusion criteria and exclusion criteria were included in this study. The mean (SD) rGFR was 81.57 (36.92) ml/min per 1.73 m(2); 18 subjects were in CKD stage I, 8 in CKD stage II, 8 in CKD stage III, and 1 in CKD stage IV. Only the mean 24 h Ccr-eGFR was slightly higher than rGFR (0.4 ml/min per 1.73 m(2) higher). Within 95% limits of agreement, the maximum absolute value of bias was about 50 ml/min per 1.73 m(2). Accuracy (estimated GFR values within ± 30% of rGFR) for all formulae was poor, ranging from 23.3% to 43.3%. All formulae overestimate or underestimate rGFR in different CKD stages.

CONCLUSIONIn Chinese children with CKD, there was a significant difference between measured GFR and estimated GFR using 24h Ccr, Schwartz formula and Filler formula. More suitable GFR predictive equations to assess glomerular function of such patients should be developed.

Adolescent ; Child ; Child, Preschool ; Female ; Glomerular Filtration Rate ; Humans ; Infant ; Kidney Failure, Chronic ; physiopathology ; Kidney Function Tests ; Male ; Renal Insufficiency, Chronic ; physiopathology