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Journal of the Korean Academy of Rehabilitation Medicine 2000;24(3):453-462.
The Clinical Effectiveness of Serial Radioisotope Renography in Evaluation of Renal Function Changes in Spinal Cord Injured Patients.
Shin, Ji Cheol , Park, Chang Il , Kim, Yong Rae , Bang, In Keol , Kim, Jung Eun
1Department of Rehabilitation Medicine, Yonsei University College of Medicine.
2Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine.
척수 손상 환자에서 신장 스캔 검사의 추적 관찰을 통한 신 기능 평가의 유용성
신지철, 박창일, 김용래, 방인걸, 김정은
연세대학교 의과대학 재활의학교실 및 재활의학연구소
Abstract

Objective
The purposes of our study were to determine the effect of serial radioisotope renography on the diagnostic evaluation and therapeutic intervention of spinal cord injured patients and to determine the characteristics of renographic findings in spinal cord injured patients.


Method
Three hundred and two spinal cord injured patients were examined with radioisotope renography using Technetium-99m mercaptoacetyltriglycine. Forty-two of 302 patients were examined in serial studies. Intravenous pyelogram, urodynamic study, 24-hour creatinine clearance, and voiding cystourethrogram were also performed. Radioisotope renography was correlated with diagnostic procedures and therapeutic interventions. Therapeutic interventions included changes in medication and bladder management.


Results
The renal functions in the left kidney were better than the functions in the right kidney after spinal cord injury (p<0.01). If neurogenic bladders were managed properly, renal functions improved after the shock stage of injury (p<0.05). Patients with significant improvement in their renal function underwent changes in proper medication and methods of bladder management (p<0.05). Renal function changes were correlated with the type of neurogenic bladder and maximal detrusor pressure (p<0.05). No significant renal function changes were found between the groups according to the completeness of injury and gender.


Conclusion
Radioisotope renography is a good initial indicator to show problems that required management changes. Serial radioisotope renographic findings give valuable informations about the urinary tract in spinal cord injured patients.

Key Words: Radioisotope renography, Renal function, Neurogenic bladder, Spinal cord injury


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