Clinical Study on the Excretion Nephrogram

Moon, Hyo Joong

Abstract

Although the opacification of the excretory nephrogram is visible on the routine intravenous urogram as well as the image of renal collecting system, the attention of the urologists and radiologists was not paid to its diagnostic value until last several years. The author has been studied on the diagnosis of so-called non-visualizing kidney utilizing the antegrade pyelography and 203Hg renal scanning with successful results. As an another diagnostic armamentarium on this field, the author came to notice the practicability of excretion nephrogram, as it outlines functioning renal parenchymal mass radiologically, even in the absence of a later pyelogram. In this paper, the author observed the opacification ratio of excretion nephrogram on the normal subjects and patients with renal disease and studied the relationship between the opacification of excretion nephrogram and degree of azotemia and blood pressure in renal failure together with the technical problems influencing the opacification. One hundred of normal subjects and 459 patients with renal disease are included in this study The results are as follows. 1. In normal subjects, the opacification ratio of excretion nephrogram is 71.78 and 77% in 5.15 and 30 minute film, respectively. 2. In the group with renal diseases, the opacification ratio of excretion nephrogram is similar to that of normal ones in most instances, while there is some fluctuations particularly in serious renal diseases. 3. Marked reduction of opacification ratio of excretion nephrogram is noticed in groups with renal failure showing more than 120 mg % of NPN, 100 mg% of BUN and 10 mg% of creatinine, as well as showing hypertension and less than 7.5gram of Hb than in groups with less azotemic, less anemic and normotensive state. 4. Excellent opacification of excretion nephrogram is found on 15 min. film while less clearly on 30 min. film and poorly on 5 min. film. 5. It is suggested that the careful intestinal lavage and large dose of x-ray medium are essential to obtain a highly opacified excretion nephrogram.