• Title/Summary/Keyword: Renal Ultrasonography

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Renal hemodynamics in dogs with experimental hydronephrosis treated with transarterial embolization of renal artery (신장동맥색전술을 실시한 개의 실험적 수신증의 혈동학)

  • Chang, Dongwoo
    • Korean Journal of Veterinary Research
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    • v.41 no.3
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    • pp.413-419
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    • 2001
  • This study was performed to evaluate the renal hemodynamics using color Doppler ultrasonography in dogs with unilateral experimental hydronephrosis treated with transarterial embolization of the renal artery (TAE-RA). Experimental hydronephrosis was induced by ligation of unilateral ureter in 12 dogs. The mean resistive index (RI) value of kidney was significantly increased at 4, 9, 17 days after ligation of ureter. Unilateral hydronephrosis was established in 12 dogs at 17 days after ligation of ureter. Renal artery embolization was performed using selective catheterization in the hydronephrotic kidney of seven dogs and EKG, $SpO_2$body temperature, pulse, and respiratory rate were within normal ranges during procedures. There were no dogs expired after TAE-RA and no side effects associated with regurgitation of iohexol-ethanol solution. In color Doppler ultrasonographic findings, there was no blood flow into the embolized kidneys treated by TAE-RA, however, blood flow signal was found in contralateral normal kidney of dogs treated with TAE-RA compared to that of normal kidney in normal control group. It is concluded that TAE-RA does not affect the hemodynamics of contralateral normal kidney in dogs with experimental hydronephrosis and color Doppler ultrasonography is simple and non-invasive modality for the monitoring of the revascularization of the renal artery after TAE-RA.

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Successful Renal Autotransplantation for the Treatment of Severe Renovascular Hypertension in a 14-year-old Boy (신 자가이식을 통한 14세 소년에서 발생한 심한 신성 고혈압의 성공적인 치료)

  • Ji, Min-Chul;Park, Se-Jin;Choi, Jae-Young;Ko, Young-Guk;Kim, Myoung-Soo;Kim, Ji-Hong;Shin, Jae-Il
    • Childhood Kidney Diseases
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    • v.14 no.2
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    • pp.223-229
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    • 2010
  • Percutaneous transluminal renal angioplasty (PTRA) is the current treatment of choice for renal artery revascularization, but renal autotransplantation has been an alternative treatment for complex cases. Here we report a 14-year-old boy with severe hypertension successfully treated with PTRA and renal autotransplantation. Doppler ultrasonography and computed tomography (CT) angiography revealed slight narrowing in the right renal artery ostium and complete obstruction in the left renal artery ostium with multiple collaterals. PTRA with stent insertion was performed for the treatment of the right renal artery, but it was impossible for the left renal artery due to the total obstruction. Therefore, left nephrectomy for autotransplantation was done with the peritoneal approach and the left kidney was autotransplanted to the ipsilateral iliac fossa. Postoperatively, Doppler ultrasonography and mercapto-acetyl-triglycine (MAG-3) renogram were performed, which showed normal renal artery blood flow and kidney function. Blood pressure was normalized and anti-hypertensive drugs were gradually tapered. Fibromuscular dysplasia was suspected to be responsible for the renal artery stenosis based on clinical aspects. In conclusion, renal autotransplantation is also a good treatment option for children with severe renovascular hypertension when endovascular treatment has failed or is not possible.

Diverse renal manifestations of Alagille syndrome in Korean children

  • Jinwoon Joung;Mi Jin Kim;Heeyeon Cho
    • Childhood Kidney Diseases
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    • v.26 no.2
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    • pp.80-85
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    • 2022
  • Purpose: To determine the prevalence, clinical manifestations, and outcomes of renal involvements in pediatric Alagille syndrome (ALGS). Methods: A total of 21 patients diagnosed with ALGS at age under 18 years who visited Samsung Medical Center from March 1999 to March 2022 were enrolled. ALGS was diagnosed either by clinical manifestations, targeted JAG1 sequencing, and/or liver biopsy. Medical records including sex, age, renal manifestations, urinalysis, serum creatinine, JAG1 sequencing, and ultrasonography were retrospectively reviewed. Results: The male to female ratio was 9:12. The mean age of patients at confirmative diagnosis of ALGS was 18.4 months. Sanger sequencing was performed for 17 patients. Sixteen of 21 patients (76.1%) showed JAG1 mutations. Renal involvement was found in 10 patients (47.6%). The most common type of anomaly was renal dysplasia (40%). One patient having renal dysplasia was pathologically confirmed with glomerular lipid deposition. Two patients (20%) manifested nephrocalcinosis/nephrolithiasis. Among eight renal-involved patients who survived, four (50%) progressed to chronic kidney disease stage 3. Two of these chronic kidney disease patients were diagnosed with hepatorenal syndrome. The other four patients had renal functions preserved, including two without any interventions and two who underwent urological interventions. Conclusions: The current study revealed a high prevalence of renal involvement in Korean pediatric ALGS with diverse phenotypes.

A Female Infant with Segmental Multicystic Dysplastic Kidney (분절형 다낭성 이형성신 영아 보고 1례)

  • Lee, Jun Ho;Kim, Moon Kyu
    • Childhood Kidney Diseases
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    • v.17 no.1
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    • pp.25-28
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    • 2013
  • There have only been 35 pediatric cases and one adult case reported on segmental multicystic dysplastic kidney (MCDK) from our search in PubMed, including 19 cases detected antenatally. There is little documentation of segmental MCDK, particularly concerning its natural history. Segmental MCDK can be presented atypically, making diagnosis more difficult. We report an another case with segmental MCDK. Multicystic abdominal mass detected on antenatal sonogram in this infant was diagnosed as segmental MCDK by renal ultrasonography and computed tomography. If a definitive diagnosis of segmental MCDK can be made on imaging, surgery is not required for a diagnostic biopsy.

Ultrasonographic Appearance in One Case of Renal Cell Carcinoma (위세포암(胃細胞癌) 1례(例)의 초음파상(超音波像)에 관(關)한 연구(硏究))

  • Han, Hye-Jin;Kim, Kang-Sueck
    • The Journal of the Korean life insurance medical association
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    • v.3 no.1
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    • pp.149-162
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    • 1986
  • We had experienced very rare a case of renal cell carcinoma through ultrasonic diagnosis, september, 1985 at medical dept. Dae Han Kyoyuk Ins. Company. The conclusions that we gained, making a comparative-analysis of operation's view and ultrasonic view are as follows; 1. Echolucent area which was $0.6cm^2$ size in the center of tumor was shown by ultrasonography, we noticed it occured necrosis or cystic change and the extracts grossly after. operation accorded with ultrasonic view. 2. Tumor was 65mm in diameter on ultrasonography and made clear 55mm in diameter after operation 3. There was not fever, anemia, even typical triad of renal cell carcinoma, blood pressure was within normal limits. 4. The case was stage I by Robson's Modification method. 5. The case was clear cell type by classifying of histology. 6. The affected site was left side and origin was lower pole of the kidney. 7. After radical nephrectomy, until present prognosis was favorable and he exists.

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Herlyn-Werner-Wunderlich Syndrome with Central Precocious Puberty: A Case Report

  • Han, Jeeho;Lee, Jae Man;Kim, Geon Hee;Kim, Su Jin
    • Childhood Kidney Diseases
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    • v.23 no.2
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    • pp.124-127
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    • 2019
  • Herlyn-Werner-Wunderlich (HWW) syndrome is a rare congenital anomaly of the genitourinary tract comprising uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis. Patients with HWW syndrome usually present symptoms such as dysmenorrhea, abdominal pain, pelvic mass, and purulent vaginal discharge. If not treated at an appropriate time, complications such as infertility, endometriosis, pyosalpinx, and subsequent pelvic adhesions may occur. Here, we report a case of HWW syndrome in a 7-year-old-girl who was also diagnosed as having central precocious puberty. She was brought to the pediatric department with chief complaints of lump in her breast and vaginal discharge. When she was around 2 months old, she was confirmed to have a single kidney on ultrasonography. We checked her past medical history and diagnosed her as having HWW syndrome based on the results of imaging studies, including abdominal ultrasonography and pelvic magnetic resonance imaging. She underwent treatment with gonadotropin-releasing hormone analogue for 2 years. During 24 months of follow-up, she showed no serious problems or complications. If renal anomalies are identified immediately after birth or in infancy, further screening tests should be conducted prior to menstruation for determining congenital abnormalities of the reproductive tract and vice versa.

Ultrasonographic Resistive Index of the Interlobar Renal Artery in Renal Failure Induced by Ochratoxin A and Citrinin Toxicosis in Dogs (Ochratoxin-A 및 Citrinin 중독 신부전 개에서 신장엽간동맥 혈관저항지수에 대한 도플러초음파 평가)

  • Bae, Jun-Woo;Seong, Yun-Sang;Oh, Tae-Ho;Jang, Kwang-Ho;Lee, Keun-Woo;Eom, Ki-Dong
    • Journal of Veterinary Clinics
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    • v.23 no.4
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    • pp.427-431
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    • 2006
  • Pulse Doppler ultrasonographic evaluation was performed to investigate the resistive index (RI) of the Interlobar renal artery in 17 dogs (32 kidneys) which were diagnosed with an acute renal failure caused by ochratoxin-A and citrinin contaminated commercial diet. RI was investigated in 7 normal beagle dogs and recovered patients. The mean of RI was resulted as $0.69{\pm}0.04$ in normal dog, however, significantly (p<0.001) increased as $0.76{\pm}0.05$ in renal failure dog. But RI had no relationship with the results of blood chemistry, urine analysis, and excretory urographic image quality. From these results, even though the results of the renal function test were within a normal reference range, it was considered that RI index is more reliable to represent a damaged renal parenchyma, and may have the potential to be a useful clinical tool in monitoring of the renal function.

Nephrotomy for Removal of Renal Calculi in Two Dog (개에서 신 절개를 통한 신 결석 제거 2례)

  • 김혜진;장화석;송영성;김성미;김순신;최치봉;김휘율
    • Journal of Veterinary Clinics
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    • v.21 no.1
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    • pp.66-71
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    • 2004
  • 2 Cases of nephrotomy for removal of calculi in dog were referred to veterinary teaching hospital of Konkuk University. In case 1, a 5 year-old, castrated male Yorkshire Terrier dog was referred because of intermittent hematuria, pain in urination for one month. Hematologic and chemical examination showed mild increased BUN and CPK. Radiographic findings revealed radiopaque materials in the urinary bladder, urethra, and left kidney. Retrograde hydropropulsion was performed to move the calculi into the bladder, and cystotomy was done to remove calculi. Nephrotomy was performed to removal of the calculi from the left renal pelvis and calyx. After operation renal function were recovered and preserved. In case 2, a 5 year-old, neutral female Schnauzer dog was referred because of persistant vomiting, anorexia, and celialgia for 20 days. Hematologic and chemical examination showed stress leucogram, moderate azotemia, hypercalcemia, hyperphosphatemia, and increased ALP. Radiographic findings revealed enlargement of the left kidney and radiopaque materials in the both of the kidneys. On excretory urography, left kidney was no pyelogram. On ultrasonography, renal tissue was very thin and distended renal pelvis appeared. Nephrectomy of nonfunctional left kidney and nephrotomy for removal of calculi from the right renal pelvis and calyx were done. One week after operation, renal and hepatic functions were recovered. So, in cases of renal calculi, it is necessary that renal calculi are extracted actively as far as the patient's body condition endurable.

Clinical Efficacy of a Top-down Approach for Children with a First Febrile Urinary Tract Infection

  • Jang, Kyung Mi;Lim, Myung Hee;Park, Yong Hoon;Kim, Saeyoon
    • Childhood Kidney Diseases
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    • v.21 no.2
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    • pp.114-120
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    • 2017
  • Purpose: The aim of this study was to determine the clinical characteristics, frequency of renal abnormalities and benefits of a top-down approach in children with their first febrile urinary tract infection (UTI). Methods: We reviewed 308 patients retrospectively who were admitted to Yeungnam University Hospital and were treated for their first febrile UTI from February 2006 to December 2013. We performed a comparative analysis of laboratory findings and results of imaging techniques including a Tc-99m dimercaptosuccinic acid (DMSA) renal scan. Results: Among the patients, 69% (213/308) were males, and 90% (277/308) had their first UTI episode during infancy. A DMSA renal scan was performed on all patients, and showed positive findings in 60% (184/308) of cases. Laboratory indices of inflammation were significantly higher in the DMSA-positive group (P< 0.05). There was a statistically significant difference in the age distribution between the two groups. In the DMSA-positive group, 165 patients underwent voiding cystourethrography (VCUG), and 58 (35%) cases demonstrated vesicoureteral reflux. In total, 110 patients in the DMSA-positive group, underwent repeat scanning at 6 months; 33 children (30%) demonstrated static scarring, but 77 (70%) had improved completely. The concordance of the ultrasonography (US) and VCUG was low. Older patients had more renal scarring. Conclusion: DMSA is a sensitive method for assessing the severity of inflammation and kidney injury. However, the ability of US to predict renal parenchymal damage was limited. A top-down approach in children with their first febrile UTI showed significant value.