Accurate determination of renal function in patients with intestinal urinary diversions
The regular determination of renal function is a critical part of the management of patients who have had the urinary tract reconstructed with intestinal segments. These intestinal segments reabsorb urinary solutes and, thereby, complicate the determination of renal function by conventional methods. Urinary clearances of urea, creatinine and inulin were performed in patients with intestinal segments in the urinary tract and controls under varying diuretic conditions. Patients with intestinal diversions also underwent radioisotopic determination of renal function. The urinary clearances of urea, creatinine and inulin are highly dependent on the rate of urine flow in patients with intestinal segments in the urinary tract. Diuresis maximizes the urinary clearances of these solutes by minimizing intestinal reabsorption. Creatinine clearance prediction from the serum creatinine underestimates true glomerular filtration rate. Radioisotopic determination of renal function correlates poorly with true glomerular filtration rate. Only creatinine clearance measured under diuretic conditions correlates well with true renal function. Urine concentrating ability cannot be assessed accurately in patients with intestinal segments in the urinary tract, since osmolality rapidly equilibrates across the segments.
- Research Organization:
- Vanderbilt Univ. School of Medicine, Nashville, TN
- OSTI ID:
- 5232611
- Journal Information:
- J. Urol.; (United States), Vol. 6
- Country of Publication:
- United States
- Language:
- English
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RENAL CLEARANCE
MEASURING METHODS
ACCURACY
CREATININE
DTPA
DYNAMIC FUNCTION STUDIES
INULIN
PATIENTS
TECHNETIUM 99
UREA
AMIDES
AMINO ACIDS
AZOLES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
CARBOHYDRATES
CARBONIC ACID DERIVATIVES
CARBOXYLIC ACIDS
CHELATING AGENTS
CLEARANCE
DRUGS
EXCRETION
HETEROCYCLIC COMPOUNDS
HOURS LIVING RADIOISOTOPES
IMIDAZOLES
IMINES
INTERMEDIATE MASS NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANIC ACIDS
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
POLYSACCHARIDES
RADIOISOTOPES
RADIOPROTECTIVE SUBSTANCES
SACCHARIDES
TECHNETIUM ISOTOPES
YEARS LIVING RADIOISOTOPES
550601* - Medicine- Unsealed Radionuclides in Diagnostics