Twenty-five patients with HUS had radionucleotide studies performed while oliguric or anuric in order to determine functional parameters and assess prognosis. 99m-Tc-DTPA (5-15 mCi) and 131-I orthoiodohippurate (50-150 muCi) were sequentially injected according to established techniques. Initially the renograms were obtained using dual scintillation probes. More recently a scintillation camera with computer was used to image sequentially the passage of these radionuclides through the kidneys. After appropriate background subtractions were made, 11 of 25 renograms were flat (same as background), with the remainder showing varying degrees of uptake. Renogram abnormalities did not correlate with symptoms, initial blood pressure levels or initial biochemical parameters (BUN, creatinine). Of the patients with a flat renogram, 8 presently have normal renal function (1-8 year follow-up) and 7 are normotensive. Thus, the presence of a flat renogram does not indicate irreversible renal damage. The observed absence of renal blood flow in HUS may be secondary to severe vasospasm caused by aggregation of platelets at sites of endothelial injury with subsequent release of vasoactive substances. The detection of platelet membrane antigen(s) and fibrin by immunohistochemical techniques supports this contention.

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Miller, K., Campos, A., Kim, Y. et al. RENOGRAM ABNORMALITIES IN THE HEMOLYTIC UREMIC 131 SYNDROME (HUS). Pediatr Res 14, 998 (1980).

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