濃縮能を中心とした分腎機能検査

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Functional examination of the kidney have made considerable progress during the last few years, thanks to the introduction of the clearance methods. However, the clearance methods determine only renal cortical function and are not sufficient to analyse renal function in urinary tract obstruction or in pyelonephritis. Furthermore, these diseases affect each of the kidneys asymmetrically. Because of these reasons, we need a technic to estimate renal medullary functions separately for the analysis of pathophysiology and for clinical diagnosis of these diseases. For this purpose, 34 patients with unilateral renal disease and 8 dogs with experimental unilateral pyelonephritis were studied. The separate function of each kidney was determined by ureteral catheterization, clearance tests with PAH (C_<PAH>) and creatinine (Ccr), assessment of EFNa and a new concentration test with water soluble vasopressin given subcutaneously. 1) By the new separated renal concentration test, we could estimate the concentrating capacities of the unilateral diseased kidneys without difficulty and in the course of these tests, patients showed no severe side effect. 2) Both unilateral obstructive kidneys and pyelonephritic kidneys had a tendency of reduction in GFR and concentrating ability. In the obstructive kidneys, the reduction in concentrating ability per GFR was slightly larger than in the pyelonephritic kidneys. 3) The kidneys with unilateral renal artery stenosis showed reduction in urine volume and EFNa and increase in concentrating ability. A unilateral hypoplastic kidney showed reduction in GFR and concentrating ability and increase in EFNa.
社団法人日本泌尿器科学会の論文

濃縮能を中心とした分腎機能検査

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