• The Korean Journal of Nuclear Medicine
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• v.36 no.4
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• pp.271-276
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• 2002

Purpose: To measure reliable glomerular filtration rate by using the representative values of transplanted renal depths, which are measured with ultrasonography. Materials and Methods: We included 54 patients (26 men, 28 women), with having both renal scintigraphy and ultrasonography after renal transplantation. We measured GFR with Gates' method using the renal depth measured by ultrasonography, and median and mean ones in each patient. We compared GFR derived from ultrasonography-measured renal depth with GFR derived from median and mean renal depths. The correlation coefficients were obtained among GFR derived from ultrasonography-measured renal depths, median and mean renal depths under linear regression analysis. We determined whether GFR derived from median or mean renal depth could substitute GFR derived from ultrasonography-measured renal depth with Bland-Altman method. We analyze the expected errors of the GFR using representative renal depth in terms of age, sex, weight, height, creatinine value, and body surface. Results: The transplanted renal depths range from 3.20 cm to 5.96 cm. The mean value and standard deviation of renal depths measured by ultrasonography are $4.09{\pm}0.65cm$ in men, and $4.24{\pm}0.78cm$ in women. The median value of renal depths measured by ultrasonography is 4.36 cm in men and 4.14 cm in women. The GFR derived from median renal depth is more consistent with GFR derived from ultrasonography-measured renal depth than GFR derived from mean renal depth. Differences of GFR derived from median and ultrasonography-measured renal depth are not significantly different in the groups classified with creatinine value, age, sex, height, weight and body surface. Conclusion: When median value is adapted as a representative renal depth, we could obtain reliable GFR in transplanted kidney simply.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.48-56
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• 2014

Purpose $^{99m}Tc$-DTPA renal scintigraphy serves as a key indicator to measure a kidney donor's Glomerular Filtration Rate (GFR) and determine the possibility of kidney transplant. The Gates method utilized to measure GFR considers 3 variables of renal depth, injection dose, and net kidney counts. In this research, we seek to compare changes in kidney donors' GFR according to renal depth measurement methods of the 3 variables. Materials and Methods We investigated 32 kidney donors who had visited the hospital from October, 2013 to March, 2014 and received abdominal CT and $^{99m}Tc$-DTPA GFR examination. With the cross-section image of the CT and the lateral image from a gamma camera, we measured the renal depth and compared with renal depth calculation equations-Tonnesen, Taylor, and Itoh methods. Renal depth-specific GFR was calculated by using Xeleris Ver. 2.1220 of GE. Then the results were compared with MDRD (Modification of Diet Renal Disease) GFRs based on serum creatinine level. Results The renal depths measured based on the CT and gamma camera images showed high correlation. Tonessen equation gave the lowest GFR value while the value calculated by using the renal depth of CT image was the highest with a 16.62% gap. MDRD GFR showed no statistically significant difference among values calculated through Taylor, Itoh, CT and gamma camera renal depth application (P>0.05), but exhibited a statistically significant change in the value based on Tonnesen equation (P<0.05). Conclusion This research has found that, in GFR evaluation in kidney donors by utilizing $^{99m}Tc$-DTPA, Tonnesen equation-based Gates method underestimated the value than the MDRD GFR. Therefore, if a MDRD GFR value shows a huge difference from the actual examination value, using an image-based renal depth measurement, instead of Tonnesen equation applied to Gates method, is expected to give an accurate GFR value to kidney donors.

• Journal of Chest Surgery
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• v.18 no.4
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• pp.718-731
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• 1985

Renal dysfunction is a common complication of open-heart surgery: a form of controlled hemorrhagic shock, and successful perioperative management of renal dysfunction depends on recognition of the risk factors and optimal management of factors influencing renal function, including cardiopulmonary bypass, and early detection of renal failure. Changes in renal functional parameters including Ccr, Cosm, CH2O, FENa, and RFI were observed prospectively in forty five patients operated on at Dept. of Thoracic and Cardiovascular Surgery, S.N.U.H., from April to June, 1985. They were 23 males and 22 females with 35 acquired and 10 congenital heart diseases and the mean age and body surface area of them were 38.010.3 years [22-63] and 1.5518 M2[1.151.92] respectively. Followings are the conclusion. 1. The Ccr, representative of renal function, is significantly improved from 90.231.3 ml/min/M2 preoperatively to 101.536.4 ml/min/M2 postoperative and day [P<0.05], and all patients were classified as postoperative renal functional class I of Abel, which representing adequate renal protection during our cardiopulmonary bypass. 2. The Cosm is significantly elevated at immediate postperfusion time and remained high at postoperative one day representing osmotic diuresis at that time, but CH2O shows no significant changes at immediate postperfusion period and is decreased significantly at postoperative one day, representing recovery of renal concentrating ability at that time with decreasing urine flow. 3. The absolute value and changing tendency in FENa and RFI during perioperative period shows no diagnostic reliability on these parameters, but those of CH2O appear to reveal future renal function more accurately than Ccr 4. The depth of hypothermia may be protective upon renal function against the ill effects of prolonged nonpulsatile cardiopulmonary bypass. 5. The depth of the hypothermia, pump time of more than 150 minutes, poor cardiac function, and intraoperative events such as embolism appear to be related with immediate postperfusion renal function. 6. Hemoglobinuria and hemolysis, poor preoperative renal function, history of cardiac surgery, and massive transfusion associated with bleeding appear not to be related with renal dysfunction.

• The Korean Journal of Nuclear Medicine
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• v.38 no.4
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• pp.306-310
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• 2004

Purpose: The aim was to assess how the background site affects the Gates' glomerular filtration rate(GFR) measurement using Tc-99m-DTPA in correlation with GFR by I-125-lothalamate method. Material and methods: The study populations were 63 adults with 39 men and 24 women aged from 20 to 59 yrs (mean=37.9 yrs). The fellowing five background regions of interest were used in measurement of GFR using Gates' method: 1) lower side of each kidney(subrenal), 2) around each kidney(circumferential), 3) upper side of each kidney(suprarenal), 4) lateral side of each kidney(lateral), 5) between the two kidneys(inter-renal). We also measured GFR using I-125-iothalamate in each subject. The two studies were separated by 1 to 3 weeks. The subjects were divided into two groups by renal depth. Group 1 with renal $depth{\geq}7cm$ and group 2 with renal depth<7cm. We calculated the means and standard deviations of the GFRs measured by two studies. And we statistically analyzed the correlation and differences among GFRs by Gates' method and the GFR by iothalamate method with correlation analysis. Results: The GFRs by Gates' method using suprarenal and inter-renal background correction showed better correlation with the GFR measured by I-125-iothalamate. And GFRs measured by Gates' method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth<7cm. But GFRs measured by Gates' method did not show statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal $depth{\geq}7cm$. Conclusion: GFRs measured with Gates' method showed higher correlation with the GFR measured by I-125-iothalamate when the regions of interest were plated over the suprarenal and inter-renal backgrounds. And GFRs measured with Gates method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth<7cm.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.1
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• pp.37-43
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• 2015

Purpose $^{99m}Tc-DMSA$ renal scintigraphy serves as location, size and shape of kidney, so it has been used for diagnosis and passage observation after the operation or treatment. There are 3 methods of calculating the relative renal uptake ratio such as geometric mean of the counts from the anterior and posterior views, arithmetical mean from the only posterior view and posterior view which applied the renal depths. In this study, we seek to correlation between the change of total relative uptake ratio according to different inspection methods of obtaining the renal count rate. Materials and Methods The phantom experiments proceeded 5 times depending on each renal depth with the kidney phantom and tissue equivalent materials. In the clinical research, we investigated 36 adult patients who had visited our hospital from february to october, 2014 and received $^{99m}Tc-DMSA$ renal scan. The equipment was used as a gamma camera named INFINIA (General Electric Healthcare, milwaukee, USA) and we drew the region of interests through semiautomatic method by using Xeleris Ver. 2.1220 of GE. In addition, we obtained the lateral view of kidney to measure the renal depth of each patient. Then the results were compared with 3 methods of calculating relative renal uptake ratio. Results The phantom studies show when the difference between the left ant right kidney depth were less than 1 cm, there were no statistically significant difference among values calculated through anterior and posterior views and only posterior view (P>0.05), while the excess of 1cm, the results showed a statistically significant change in the value (P<0.05). In case of clinical research, the correlation between total relative uptake ratio by obtaining both sides of image and posterior view applied the kidney depth (r=0.999) was higher than by obtaining only posterior view and applying the kidney depth to one side image (r=0.988). Conclusion This study has found that, the difference of calculating total relative uptake ratio compared with obtaining anterior and posterior views and only posterior view. In order to reduce the error, we recommend the method of obtaining anterior and posterior views and is considered to be useful, particularly the patients have similar uptake ratio of left and right kidney and difficulties of measurements of kidney depth.

• Clinical and Experimental Pediatrics
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• v.63 no.12
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• pp.491-498
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• 2020

Background: Renal size is an important indicator in the diagnosis of renal diseases and urinary tract infections in children. Purpose: The purpose of this study is twofold. First, it aimed to measure the renal length and calculate the renal volume of normal Thai children using 2-dimensional ultrasonography (2D-US) and study their correlations with somatic parameters. Second, it aimed to compare the age-specific renal size of normal Thai children with the published data of their Western and Chinese counterparts. Methods: A total of 321 children (150 boys, 171 girls; age, 6-15 years) with a normal renal profile were prospectively recruited. All subjects underwent 2D-US by an experienced pediatric radiologist and the renal length, width, and depth were measured. Renal volume was calculated using the ellipsoid formula as recommended. The data were compared between the left and right kidneys, the sexes, and various somatic parameters. The age-specific renal lengths were compared using a nomogram derived from a Western cohort that is currently referred by many Thailand hospitals, while the renal volumes were compared with the published data of a Chinese cohort. Results: No statistically significant difference (P<0.05) was found between sexes or the right and left kidneys. The renal sizes had strong correlations with height, weight, body surface area, and age but not with body mass index. The renal length of the Thai children was moderately correlated (r=0.59) with that of the Western cohort, while the age-specific renal volume was significantly smaller (P<0.05) than that of the Chinese children. Conclusion: Therefore, we concluded that the age-specific renal length and volume obtained by 2D-US would vary between children in different regions and may not be suitably used as an international standard for diagnosis, although further studies may be needed to confirm our findings.

• Journal of Korean Academy of Nursing
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• v.31 no.4
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• pp.525-537
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• 2001

The Purpose of the study was to understand the experience of chronic renal failure patients for the qualified individual care for them. The purpose of this study was to explore the experience of patients living with chronic renal failure and to identify the meaning and structure of their experience. The subjects were four patients, two females and two males. The age range was from 21 to 54. Data was collected with a few in-depth interviews by the authors until the data was fully saturated. The framework and methodology of this study was based on Parse′s "Human Becoming methodology," an existential phenomenological research methodology. The findings of this study were as follows. Three experience structures of chronic renal failure patients were : 1. Sufferings and conflicts originated in the frustration caused by uncurable disease. 2. Dependence upon God and significant others with complex emotions. 3. Acceptance of sufferings, emerging hope for serving people, and gratitude for living. In conclusion the experience of chronic renal failure patients could be described from the findings (three structures) as "Experiencing the sufferings, conflicts originated in the frustration caused by uncurable disease, dependence upon God and significant others with complex emotion, acceptance of the suffering and hope for serving people, and gratitude for living." The three structures of the lived experience of patients with chronic renal failure, the findings of this study, could be explained by the three concepts of "Theory of Human Becoming," the first structure could be explained with values, the second with revealing-concealing, and the third with transforming.

• Journal of radiological science and technology
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• v.39 no.2
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• pp.199-208
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• 2016

$^{99}mTc-MAG_3$ Renal scan is a method that acquires dynamic renal scan image by using $^{99}mTc-MAG_3$ and dynamically visualizes process of radioactive agent being absorbed to kidney and excreted continuously. Once the test starts, ratio in both kidneys in 1~2.5 minutes was measured to obtain split renal function and split renal function can be expressed in ratio based on overall renal function. This study is based on compares split renal function obtained from data acquired from posterior detector, which is a conventional renal function test method, with split renal function acquired from the geometric mean of values obtained from anterior and posterior detectors, and studies utility of attenuation compensation depending on difference in geometric mean kidney depth. From July, 2015 to February 2016, 33 patients who undertook $^{99}mTc-MAG_3$ Renal scan(13 male, 20 female, average age of 44.66 with range of 5~70, average height of 160.40cm, average weight of 55.40kg) were selected as subjects. Depth of kidney was shown to be 65.82 mm at average for left and 71.62 mm at average for right. In supine position, 30 out of 33 patients showed higher ratio of deep-situated kidney and lower ratio of shallow-situated kidney. Such result is deemed to be due to correction by attenuation between deep-situated kidney and detector and in case where there is difference between the depth of both kidneys such as, lesions in or around kidney, spine malformation, and ectopic kidney, ratio of deep-situated kidney must be compensated for more accurate calculation of split renal function, when compared to the conventional test method (posterior detector counting).

• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.248-255
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• 1993

To Assessment of the quantified renal uptake rates in every $^{99m}Tc$-DMSA scan tests of patients is actually difficult because of time consumption and complicated calculations required to measure the correct dose of the infused radionulide and radiation decay, the adjustment for the depth of kidney and the subtraction of background count. We've formulated two regression models for the quantified renal uptake rates[I] from the simple renal uptake rates[H] with a square shaped ROI (Region-Of-Interest) in 25 cases (Group 1) and with a kidney shaped ROI in 37 cases (Group 2), respectively. The regression model for the Group 1 was $[I]_1$=0.885 $[H]_1$-4.575 (P<0.005), and for the Group 2 was $[I]_2$=0.591 $[H]_2$-2.105 (p<0.005). The formal charts were clinically convenient to evaluate the individual renal functions in patients with $^{99m}Tc$-DMSA renal scan.

• Journal of Veterinary Clinics
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• v.22 no.2
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• pp.119-124
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• 2005

This study was performed to validate the procedure of transarterial embolization of the renal artery (TAE-RA) and sclerotherapy of renal pelvis using iohexol-ethanol solution in dogs with unilateral experimental hydronephrosis. Experimental hydronephrosis was induced by unilateral ureter ligation for 20 days in five Beagle dogs. Renal artery embolization with iohexol-ethanol solution was performed using selective catheterization technique in the hydronephrotic kidney and sclerotherapy was done by injection of the iohexol-ethanol solution through percutaneously placed pig-tail catheter. EKG, $SpO_2$ body temperature, pulse, and respiratory rate were within normal ranges during procedures. Average pure ethanol dose for renal artery embolization was $1.1\pm0.3ml/kg$. Renal artery embolization was confirmed by the detection of no blood flow signal at the interlobar and arcuate artery using color Doppler ultrasonography. There were no dogs expired after TAE-RA and sclerotherapy and no side effects associated with regurgitation of iohexol-ethanol solution. The value of BUN, creatinine, ALT, AST, Ca, P in five dogs were within normal range during the experiment period. Ultrasonographically, the mean longitudinal and transverse length and the depth of the embolized kidney significantly decreased at 28 days after TAE-RA. We may conclude that TAE-RA and sclerotherapy with iohexol-ethanol solution is an effective methods for the treatment of unilateral hydronephrosis in dogs.