Abstract:
Objective To investigate the application of 99Tcm-diethylene-triaminepentaaccetic acid (99Tcm-DTPA) dynamic renal imaging in evaluating the compensatory function of healthy kidneys in patients with unilateral hydronephrosis.
Methods A total of 257 cases of unilateral hydronephrosis admitted to the Second Hospital of Tianjin Medical University from January 2016 to July 2019 were retrospectively analyzed. They included 149 males and 108 females, aged 12~87 (52.84±14.23) years. All patients underwent 99Tcm-DTPA renal dynamic imaging, and their glomerular filtration rate (GFR) was counted using the Gates method. They were also grouped in accordance with the degree of hydronephrosis, the degree of renal impairment, gender, age, and etiology. The GFR compensation rate (%) of the uninfected kidney in different groups was calculated. The GFR of both kidneys was compared using independent sample t-test. The influencing factors of the compensatory ability were analyzed using the Mann-Whitney U and Kruskal-Wallis tests.
Results The GFR of the affected kidney was (28.60±15.13) mL/min, while that of the contralateral kidney was (63.17±15.74) mL/min, and the total GFR was (92.94±24.46) mL/min. The GFR of the affected kidney was significantly lower than that of the contralateral kidney (t=25.39, P<0.001). Varying degrees of compensatory increase were observed in the GFR of the uninfected kidney, the GFR compensation rate was 9.54% (−5.94%, 26.45%). Statistically significant differences were also found in the GFR compensation rate of the contralateral kidney among patients of different ages and degrees of hydronephrosis (χ2=47.32, 12.71, both P<0.01). No statistically significant difference was found in the GFR compensation rate of the contralateral kidney among patients with different degrees of renal damage on the affected side, the location of hydronephrosis, the location of the stones, and gender (χ2=4.34, Z=−0.51, −1.62, −1.41, all P>0.05).
Conclusion Using renal dynamic imaging to study the factors affecting the compensatory ability of the contralateral kidney in patients with unilateral hydronephrosis could further provide a basis for the diagnosis, treatment, and prognostic evaluation of these patients.