Clinical Investigation

Kidney International (1981) 19, 49–57; doi:10.1038/ki.1981.6

Assessment of total and divided renal plasma flow by 123I-hippuran renography

Alistair Mackay, Andrew S Eadie, Alison M M Cumming, Andrew G Graham, Frederick G Adams and Patrick W Horton

1MRC Blood Pressure Unit, Department of Urology, Department of Radiology, Western Infirmary, Glasgow, and Department of Clinical Physics and Bioengineering, West of Scotland Health Board, Glasgow, Scotland

Correspondence: Dr A Mackay, MRC Blood Pressure Unit, Western Infirmary, Glasgow G11 6NT, Scotland.

Received 29 November 1979; Revised 28 April 1980.

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Abstract

Assessment of total and divided renal plasma flow by 123I-hippuran renography. We studied 23 patients with suspected renal hypertension, including 12 with renal artery stenosis, or occlusion. Total effective renal plasma flow (ERPF) was measured in all patients by conventional p-aminohippurate (PAH) clearance and by 123I-hippuran clearance performed on the same day. A close correlation between the two techniques was obtained (r = 0.87, P < 0.001) with the latter technique underestimating the former by a mean ratio of 0.89:1.00. We describe a technique for deriving ERPF for individual kidneys by 123I-hippuran renography, and the data obtained by this method correlate well with data obtained from bilateral ureteric catheterization studies (r = 0.76, P < 0.001 for both affected and unaffected sides) in 17 patients. The renographic technique is particularly accurate in quantitating ERPF in the 12 patients with renal artery stenosis, and is recommended as the investigation of choice in the assessment of ERPF in patients with this condition.

Evaluation des débits plasmatiques rénaux total et séparés au moyen de la rénographie au 123I-hippuran. Vingt trois malades ayant une hypertension d'origine rénale présumée, incluant 12 sténoses ou occlusions d'artères rénales, ont été étudiés. Le débit plasmatique rénal total effectif (ERPF) a été mesuré chez tous les malades par la clearance du para-aminohippurate (PAH) et par la clearance du 123I-hippuran réalisées le même jour. Une corrélation étroite entre les deux techniques a été observée 0 = 0,87; P < 0,001), celle de l'hippuran étant inférieure à celle du PAH d'un facteur 0,89:1,00. Une technique d'évaluation d' ERPF de chaque rein au moyen de la rénographie au 123I-hippu-ran est décrite. Les valeurs obtenues par cette méthode sont bien corrélées avec celles fournies par la cathétérisation ur-étérale bilatérale (r = 0,76; P < 0,001) chez 17 malades. Il est apparu que la technique rénographique est particulièrement précise pour l'évaluation d'ERPF chez 12 malades atteints de sténose de l'artère rénale. Elle est recommandée comme investigation de choix dans l'évaluation d'ERPF chez les malades ayant ce type d'atteinte.

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