ABSTRACTS PRESENTADOS AL 11th INTERNATIONAL SYMPOSIUM "RADIONUCLIDES IN NEPHRO-UROLOGY", REALIZADO EN MONTEREY, CALIFORNIA, 13-17 MAYO 2001.

Y. Horita(1,2), K. Hayashida(1), Y.Kawano(1) , K. Fukuchi(1), M. Miyazaki(2), M. Tadokoro(3), K. Taura(3), Y. Ozono(2), and S. Kohno(2).

(1)National Cardiovascular Center, Osaka,
(2)Nagasaki University School of Medicine,
(3)Nagasaki Municipal Chronic Disease Center, Nagasaki, Japan.

chihomiy@jaz.so-net.ne.jp

Purpose: The aim of this study was to determine whether or not Tc99mMAG-3 renography can stratify the severity of renal parenchymal damage related to angiopathy in patients with normal, hypertension and diabetes with hypertension by combining baseline with Acetazolamide (ACZ), an inhibitor of carbonic anhydrase, renography.

Methods: We obtained the informed consent of 30 patients to participate in this study of baseline and ACZ renography. There were divided into three groups of 10 each as follows: normal (NR), essential hypertension (EH) and Type 2 diabetes with hypertension (DM). We performed baseline renography for 20 min after an injection of 370 MBq Tc99mMAG-3, followed by ACZ renography performed in the same manner 10 min after a 1g injection ACZ.

Quantitative analyses included tubular extraction rate (TER), effective renal plasma flow (ERPF) and time to the maximum activity of the renal curve (Tmax) determined using the deconvolution method applied to the time activity curve of Tc99mMAG-3 in the kidneys. The percent change in TER (ERPF and Tmax) between the baseline and ACZ renography was obtained in the following manner: %TER (%ERPF and %Tmax) = [ACZ TER (ERPF and Tmax) - baseline TER (ERPF and Tmax)] x 100/baseline TER (ERPF and Tmax) Corrected %TER (%ERPF and % Tmax) was then obtained by subtracting the variation in %TER (%ERPF and % Tmax) between baseline and sequential renograms derived from 10 control patients (CR group) injected with distilled water, from those injected with ACZ.

Results: These parameters did not significantly differ between the NR and EH groups, but the differences between the DM and NR groups and between the DM and EH groups were significant (p<0.01).

Conclusion: Combined baseline and ACZ Tc99mMAG-3 renography can evaluate renal vascular reverse, a loss of which could represent microangiopathy in diabetic patients.