The Clinical Effectiveness of Serial Radioisotope Renography in Evaluation of Renal Function Changes in Spinal Cord Injured Patients

ABSTRACT

OBJECTIVE: The purposes of our study were to determine the effect of serial radioisotope renography on the diagnostic evaluation and therapeutic intervention of spinal cord injured patients and to determine the characteristics of renographic findings in spinal cord injured patients. METHOD: Three hundred and two spinal cord injured patients were examined with radioisotope renography using Technetium-99m mercaptoacetyltriglycine. Forty-two of 302 patients were examined in serial studies. Intravenous pyelogram, urodynamic study, 24-hour creatinine clearance, and voiding cystourethrogram were also performed. Radioisotope renography was correlated with diagnostic procedures and therapeutic interventions. Therapeutic interventions included changes in medication and bladder management. RESULTS: The renal functions in the left kidney were better than the functions in the right kidney after spinal cord injury (p<0.01). If neurogenic bladders were managed properly, renal functions improved after the shock stage of injury (p<0.05). Patients with significant improvement in their renal function underwent changes in proper medication and methods of bladder management (p<0.05). Renal function changes were correlated with the type of neurogenic bladder and maximal detrusor pressure (p<0.05). No significant renal function changes were found between the groups according to the completeness of injury and gender. CONCLUSION: Radioisotope renography is a good initial indicator to show problems that required management changes. Serial radioisotope renographic findings give valuable informations about the urinary tract in spinal cord injured patients.